Abstracts from the ASMIRT 2026 Conference, 26-29 March 2026, Hobart.

Oral Abstracts - PMC Skip to main content An official website of the United States government Here's how you know Here's how you know Official websites use .gov A .gov website belongs to an official government organization in the United States. Secure .gov websites use HTTPS A lock ( Lock Locked padlock icon ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites. Search Log in Dashboard Publications Account settings Log out Search… Search NCBI Primary site navigation Search Logged in as: Dashboard Publications Account settings Log in Search PMC Full-Text Archive Search in PMC Journal List User Guide PERMALINK Copy As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Learn more: PMC Disclaimer | PMC Copyright Notice J Med Radiat Sci . 2026 Mar 13;73(Suppl 1):S4–S85. doi: 10.1002/jmrs.70065 Search in PMC Search in PubMed View in NLM Catalog Add to search Oral Abstracts Article notes Copyright and License information Accepted 2026 Jan 15; Issue date 2026 Mar. Editorial material and organization © 2026 Australian Society of Medical Imaging and Radiation Therapy. Copyright of individual abstracts remains with the authors. PMC Copyright notice PMCID: PMC13097326  PMID: 41821386 Friday 27 March, 11:00 AM – 12:30 PM Navigating Neurodiverse Care Autistic children and their parents' experience of diagnostic imaging Jane Harvey‐Lloyd 1 1 University of Leeds, Leeds, United Kingdom Introduction: Autism is a neuro‐developmental condition that affects the social‐emotional skills, behaviour, language, communication skills and flexibility of thoughts of an individual and their sensory processing. This can result in autistic service users finding it difficult to navigate current healthcare provision and cope with the unpredictable environment. This presentation explores the experiences of parents of autistic children when attending the diagnostic imaging department for an X‐ray examination. Methods: A cross sectional, mixed methods approach was adopted, the initial phase consisting of an online survey for parents followed by five interviews with children and their parents. The quantitative data was analysed using descriptive statistics and cross comparison between questions was also completed. The two open questions from the survey and the data from the interviews were thematic analysed, drawing themes together. Results: The quantitative data from the online survey results are presented in this presentation and the qualitative data is discussed under four key themes: 1) waiting times and environment; 2) forms of communication; 3) lack of understanding of staff regarding autism; and 4) preparation for the X‐ray examination. Direct quotations from the interviews will be used to illustrate the findings. Conclusion: The overall rating of the parents’ experience while in the X‐ray/diagnostic imaging department was positive, however several areas need further attention. These were: waiting areas, waiting times, staff development, and patient preparation. These themes were also highlighted by the interviews alongside some individual experiences and direct quotations will be used to inform the discussion. Neurodivergence and medical radiation professionals: Beyond the myth that ‘everyone is a little neurodivergent’ Sharon Ponniah 1 1 St Vincent's Hospital Melbourne, Fitzroy, Australia Neurodivergence has become a hot topic, especially in the wake of the COVID‐19 pandemic. Increasingly, it is evident that a significant proportion of medical radiation professionals and students are neurodivergent. Drawing from my own journey from navigating university and clinical placements without a diagnosis, and eventually taking on a clinical educator role several years after diagnosis, I will share practical tools and personal insights gained as a neurodivergent radiographer. This presentation will explore the unique strengths neurodivergent individuals bring to radiography and highlight why this field is an absolutely fantastic career choice for neurodivergent people. Improving emergency care for autistic and ADHD adults: The NEEDs Project Ben Potts 1,2 , Christina Malamateniou 1 , Themis Karaminis 1 , Emily Skelton 1 , Georgia Pavlopoulou 1 1 City St George's, University of London, London, United Kingdom 2 University Hospital Southampton, Southampton, United Kingdom Emergency departments are busy, fast‐paced environments designed to treat people who are very unwell or critically injured. But for many autistic, ADHD or AuDHD people, visiting an emergency department can be an overwhelming, distressing and sometimes traumatic experience. A growing body of international research reveals that neurodivergent people experience higher rates of unmet health needs, longer diagnostic delays and poorer treatment outcomes compared with the general population. 1‐3 Many of the barriers contributing to this inequity – such as sensory overload and ambiguous communication – are particularly evident in the emergency department. Understanding and addressing these challenges is therefore essential. This presentation will examine the emerging evidence on these disparities and highlight what must change to achieve equitable emergency care. Drawing on studies from the United Kingdom, Scandinavia and Australia, it identifies recurring issues such as the invisibility of neurodivergent needs in triage systems, the over‐reliance on verbal communication and the lack of environmental or procedural flexibility. It also showcases promising examples from practice, including sensory‐adapted spaces, accessible communication strategies and staff training in neuro‐inclusive care. For radiographers, radiologists and other medical professionals, these insights are directly relevant. Imaging forms a crucial part of many emergency pathways, and the environments and interactions within radiology departments can strongly influence whether neurodivergent patients feel safe, understood and able to complete their treatment journey. By recognising and addressing these barriers, imaging professionals can play a vital role in improving access, reducing distress and promoting equity across the patient journey. References 1. Weir E, Allison C, Baron‐Cohen S. Autistic adults have poorer quality healthcare and worse health based on self‐report data. Mol Autism 2022;13(1):23. 2. Arnold SRC, Bruce G, Weise J, et al. Barriers to healthcare for Australian autistic adults. Autism 2023;28(2):301–15. 3. Doherty M, Neilson S, O’Sullivan J, et al. Barriers to healthcare and self‐reported adverse outcomes for autistic adults: a cross‐sectional study. BMJ Open 2022;12(2):e056904. Diagnosed late, thriving anyway: Navigating radiography with adult ADHD Emily Ross 1 1 Austin Health, Melbourne, Australia I was diagnosed with adult ADHD after 6 years working in radiography, and in the context of a previously unrecognised family history of neurodivergence. ADHD is often misunderstood as a childhood disorder, stereotyped as hyperactive boys. In reality, it is primarily an executive function disorder. 1 Disruptions in frontal‐lobe circuits and dopamine‐driven pathways affect planning, working memory, emotional regulation and self‐motivation. 2 Female ADHD is particularly under‐recognised, as masking, social expectations and perfectionism often obscure symptoms. 3 This presentation blends neurobiological insight with lived experience to explore working as a female radiographer with ADHD, both before and after a formal diagnosis. Challenges such as executive dysfunction, overstimulation, masking and burnout can impact workflow, time management and decision‐making. Conversely, neurodivergent clinicians often demonstrate strengths in hyper‐focus, creativity, adaptability, problem‐solving and empathy – qualities that enhance patient care and team function. Practical strategies for neuro‐inclusive healthcare teams are presented, including clear communication, flexible supervision, mentorship, sensory‐friendly environments and inclusive policies. These approaches support clinicians, optimise professional wellbeing and enhance patient‐centred practice. By reframing ADHD as a difference rather than a deficit, this session highlights the value of recognising diverse cognitive styles in medical imaging. Supporting neurodivergent clinicians strengthens team collaboration, professional performance and patient outcomes, demonstrating that inclusive practice benefits both individuals and the broader healthcare environment. References 1. Barkley RA. Attention‐deficit hyperactivity disorder: a handbook for diagnosis and treatment. 4th edn. New York: Guilford Press; 2015. 2. Nigg JT. Attention‐deficit/hyperactivity disorder and executive functioning. Curr Dir Psychol Sci 2005;14(5):237–41. 3. Quinn PO, Madhoo M. A review of attention‐deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis. Prim Care Companion CNS Disord 2014;16(3). Friday 27 March, 11:00 AM – 12:30 PM CT in Focus (MI) Discovery through dual‐energy CT: Differentiating common medications and food from true pathological findings Xanthe Keneally 1 , Roisin Lynam 1 , Jit Pratap 1 , Tom Steffens 1 1 Princess Alexandra Hospital, Brisbane, Australia Introduction: Unexpected intraluminal hyperdensities on CT can mimic pathology, foreign bodies or obscure anatomy. These hyperdensities can be misinterpreted as an acute gastrointestinal bleed or mask underlying pathology through artefact production, reducing the specificity of CT. 1 Certain medications have been reported to be the cause of unexpected hyperdensities, 1‐3 however, there is currently minimal literature on the characteristics of medications or food on CT. Dual‐energy CT (DECT) allows for the composition of structures to be analysed by comparing the Hounsfield units at two energy levels. 4 This study aimed to characterise DECT findings of common medications and foods to enable confident distinction from true pathology. Method: Several common medications (oral and rectal) and foods were placed in syringes and scanned within a water bath using single‐energy and DECT on a dual source Somatom Force scanner. The mean Hounsfield units at both energies, dual‐energy index, atomic number and electron density were recorded, with water as a control. This data was compared to those of human tissues, acute bleeding and iodinated contrast media reported in the literature. Results: Initial findings revealed that some common medications and foods can mimic pathologies when scanned with single‐energy CT but can be resolved with greater confidence using DECT. Conclusion: This study aims to support radiologists in distinguishing true gastrointestinal pathology from imaging appearances caused by medications and ingested food. By leveraging the material‐specific characteristics provided by DECT, particularly in the context of suspected gastrointestinal bleeding, this approach enhances diagnostic confidence and reduces the risk of misinterpretation. References 1. Sin FNY, Tsang JPK, Siu KL, Ma JKF, Yung AWT. Medications as causes of intraluminal hyperdensities: what radiologists need to know. Eur J Radiol 2012;81(7):1652–6. https://doi.org/10.1016/j.ejrad.2011.03.010 2. Harper R, Friedman BT, Strote J. Missed appendicitis: did unexpected intraluminal densities play a role? BMJ Case Rep 2016. https://doi.org/10.1136/bcr‐2016‐216241 3. Coelho MP, Goel A, Klumpp M, Mincolla M. Intraluminal hyperdense appearance of the small bowel on high resolution computed tomography of the abdomen and pelvis secondary to the use of calcium carbonate tablets (Tums) mimicking a small bowel fistula. J Radiol Case Rep 2020;15(10):1875–8. https://doi.org/10.1016/j.radcr.2020.07.044 4. Johnson TRC. Dual‐energy CT: general principles. Am J Roentgenol 2012;199(5). https://doi.org/10.2214/AJR.12.9116 Finding the right path: Navigating the wilderness of CT training Louise Murray 1 1 Royal Melbourne Hospital, Parkville, Australia There is an ongoing shortage of experienced CT radiographers and an ever‐increasing demand for CT services in Victoria. 1 This project aims to reduce workplace pressure at a Victorian trauma centre/tertiary hospital by improving training for junior staff entering CT. Previously, CT training did not have clear learning goals or expectations. This made it difficult for the education team to assess readiness and led to a workforce with varied competencies and limited clarity on performance standards. Aligned with Domain 3, Part 2 of the Medical Radiation Practice Board of Australia's Professional Capabilities for Medical Radiation Practitioners, a structured CT training rubric was developed to provide a standardised framework outlining expectations, performance indicators and progression milestones across three competency levels. Completed at regular intervals, the rubric aims to support trainees in becoming competent CT radiographers. The rubric allows educators and supervising radiographers to provide constructive, consistent feedback to trainees. It also allows trainees to set specific goals and reflect during their training period. The impact of the CT training rubric will be evaluated through surveys, focussing on indicators such as perceived access to learning opportunities, confidence in review processes and sense of support within the workplace. Improvement in these measures over time will enhance departmental culture, staff engagement and retention. If successful, the training rubric will be rolled out across the department for broader modality training. The goals of the project are to foster a growth‐focussed learning environment in radiology, enhancing educator confidence, supporting junior staff development and promoting long‐term career engagement. Reference 1. Victorian Skills Authority. 2022. Health and community services industry insight. Available at https://www.vic.gov.au/sites/default/files/2022‐10/Health‐and‐Community‐Services‐industry‐report‐Final.pdf National diagnostic reference levels for adult and paediatric CT update Jason Sparks 1 , Peter Thomas 1 , Toby Beveridge 1 , Kam Lee 1 , Masoumeh Sanagou 1 1 Australian Radiation Protection and Nuclear Safety Agency, Melbourne, Australia Introduction: Diagnostic reference levels (DRLs) are an essential tool for optimising radiation dose in medical imaging. In July 2025, the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) updated the Australian national DRLs for multi‐detector CT scans for both adult and paediatric patients to reflect current clinical practices and technological advancements. Methods: Data was collected via the National Diagnostic Reference Level Service from over 600 facilities across Australia during the 2023 calendar year. A liaison panel, comprising representatives from relevant professional bodies, reviewed the data compiled by ARPANSA and established updated DRLs. Adult DRLs were expanded to include two new scan types: paranasal sinuses and low‐dose chest CT. Paediatric DRLs were revised to adopt age‐based bands for head scans and weight‐based bands for body scans, aligning with ICRP Publication 135 recommendations. 1 Results: The updated adult DRLs show a reduction in volume computed tomographic dose index (CTDIvol) and dose‐length product across all adult CT scan types. 2 For example, the non‐contrast brain scan DRL was set at 45 mGy CTDIvol and 820 mGy·cm dose‐length product. Figure 1 illustrates a representative trend, displaying the radiation dose metric, dose‐length product, utilised between 2012 and 2025 for abdomen‐pelvis CT examinations. Paediatric DRLs now provide more granular guidance, improving dose management across diverse patient sizes and ages. Conclusion: The 2025 update to CT DRLs continues the important role ARPANSA plays in supporting patient safety and dose optimisation in medical imaging. Facilities are encouraged to compare their facility reference levels against these benchmarks to identify opportunities for improvement. References 1. International Commission on Radiological Protection (ICRP). Diagnostic reference levels in medical imaging. ICRP Publication 135. Ann ICRP 2017;46(1). 2. Australian Radiation Protection and Nuclear Safety Agency (ARPANSA). National diagnostic reference level service [Internet]. Available at https://www.arpansa.gov.au/research‐and‐expertise/surveys/national‐diagnostic‐reference‐level‐service Evaluation of low‐value wrist/hand CTs in emergency: A 12‐month review and cost analysis Kevin Weeks 1 , James Pearce 1 , Benito Virgona 1 , Kate Saunder 1 , Shannon Crick 1 , Joshua Griffin 1 , Elyse Horne 1 , Timothy Keun 1 , Phillip Newman 2 1 North Canberra Hospital, Canberra, Australia, 2 University of Canberra Research Institute for Sport and Exercise, Canberra, Australia Introduction: CT scanning has rapidly increased globally over the past few decades. 1,2 Inappropriate imaging poses a significant challenge for healthcare systems, contributing to higher costs, overdiagnosis and incidental findings that may lead to unnecessary testing and treatment. 1,3 Methods: A retrospective observational cohort study of all non‐contrast wrist or hand CTs ordered at an emergency department (ED) over 12‐months. We identified low‐value CT orders, reasons why they were ordered, and to calculate the financial, radiation and time costs. Results: 55% of CTs analysed were classified as low value. The most common categories were occult, distal pole or waist scaphoid fractures (39%) and cases where no radiographical nor clinical findings indicated the need for CT (31%). 49% of CTs still went ahead because a specialty or senior ED doctor approved the order. The average financial cost was $355.35 per scan and report, totalling $38,022.45 over 12 months. The mean time cost was 2 hours and 32 minutes per patient spent in the ED after the CT was ordered. Mean radiation doses were 0.01 mSv per CT. 45% of CTs analysed were considered high value, of which 54% of these were for operative planning or to determine surgical versus conservative management. Conclusion: Low‐value wrist/hand CTs represent a financial, time and radiation cost to the ED. Our results could be used to inform changes in practice to reduce the number of low‐value CTs, e.g. modifications to the existing orthopaedic pathways, targeting scaphoid‐related presentations where CT is not high‐value, and education of senior ED staff around costs associated with CT ordering. References 1. Maxwell S, Ha NT, Bulsara MK, et al. Increasing use of CT requested by emergency department physicians in tertiary hospitals in Western Australia 2003–2015: an analysis of linked administrative data. BMJ Open 2021;11(3):e043315. 2. Brownlee S, Chalkidou K, Doust J, et al. Evidence for overuse of medical services around the world. Lancet 2017;390(10090):156–68. 3. Department of Health and Aged Care. 2022. Reducing overuse of diagnostic imaging: project report. Available at https://www.health.gov.au/sites/default/files/2023‐02/reducing‐overuse‐of‐diagnostic‐imaging‐project‐report.pdf Friday 27 March, 11:00 AM – 12:30 PM Precision in Motion (RT) When the anatomy shifts: Daily rectal IGRT variability and the case for selective adaptation Meegan Shepherd 1,2 , George Hruby 1 , Stephanie Roderick 1 , Shelley Wong 1 , Maegan Stewart 1 , John Atyeo 1,2 1 Royal North Shore Hospital, St Leonards, Australia, 2 Monash University, Clayton, Australia Introduction: The role of radiation therapy in rectal cancer management has evolved since the OPERA trial, 1 with total neoadjuvant therapy and organ preservation increasingly integrated into contemporary practice. Most centres, however, continue to rely on image guided radiotherapy (IGRT) where a single non‐adaptive plan is delivered despite daily anatomical changes. Understanding when and for whom adaptation adds value is essential for margin management, organ preservation and optimal use of departmental resources. Case Presentation: A 45‐year‐old male with locally advanced rectal cancer received 45–54 Gy (54 Gy integrated boost) in 25 fractions using intensity modulated radiation therapy and cone beam CT IGRT with concurrent oral chemotherapy. Images were assessed for bladder volume, gross tumour volume (GTV) change, planning target volume (PTV) coverage and body variation relative to the reference CT (Fig. 1). Outcome: Across the 25 fractions, excellent agreement of daily IGRT and reference CT was observed, confirming high reproducibility. However, progressive tumour shrinkage and geometric GTV displacements were seen, occasionally extending beyond standard PTV margins. This was associated with bladder or rectal geometric variation. Interestingly, no additional imaging or replanning was required. All fractions were delivered in ≤7 minutes, in contrast to adaptive studies with 20–30 minutes additional workflow time. 2 Discussion: This case demonstrates IGRT's operational reliability, feasibility and efficiency, but highlights vulnerability to target and organ variation, particularly late in the course. With GTV geometric displacements observed, margin reduction without adaptive correction is not indicated. Based on the evidence of this case, investigation into selective adaptation strategies warrants further review with larger patient numbers in rectal cancer. ³ References 1. Gerard JP, Barbet N, Schiappa R, et al; ICONE group. Neoadjuvant chemoradiotherapy with radiation dose escalation with contact x‐ray brachytherapy boost or external beam radiotherapy boost for organ preservation in early cT2‐cT3 rectal adenocarcinoma (OPERA): a phase 3, randomised controlled trial. Lancet Gastroenterol Hepatol 2023;8(4):356–67. https://doi.org/10.1016/S2468‐1253(22)00392‐2 2. deJong R, Visser J, van Wieringen N, et al. Feasibility of conebeam CT‐based online adaptive radiotherapy for neoadjuvant treatment of rectal cancer. Radiat Oncol 2021;16(1):136. https://doi.org/10.1186/s13014‐021‐01866‐7 3. Chen X, Cui J, Zhu J, et al. Estimation of adaptive radiation therapy requirements for rectal cancer: development and external validation of a model. Radiat Oncol 2024;19(1):2567. https://doi.org/10.1186/s13014‐024‐02567‐7 Breath by breath: Listening to patients, adapting techniques, discovering precision in radiation therapy Briana Farrugia 1,2 , Caroline Wright 2 , Kellie Knight 2 , Mark Tacey 1 , Farshad Foroudi 1 , Richard Khor 1 1 Olivia Newton‐John Cancer & Wellness Centre, Heidelberg, Australia, 2 Monash University, Melbourne, Australia Introduction: Breath hold (BH) for respiratory motion management in upper abdominal radiation therapy facilitates safe dose‐escalation. However, patient‐specific compliance and tolerance vary. This prospective clinical trial aimed to evaluate an individualised screening process to select the optimal BH technique and assess performance. Methods: Patients referred for upper abdominal radiation therapy were invited to participate. Participants underwent screening to personalise selection of BH technique, using Active Breathing Coordinator. Tumour position reproducibility and stability were measured with kV fluoroscopy, and along with BH duration, determined the optimal technique using a novel pre‐defined decision matrix. Patient perspectives were evaluated by survey and interview. BH efficiency was calculated during the first three fractions, as a ratio of beam‐on to total treatment time. Results: 19 participants (liver: n = 14; adrenal gland: n = 5; kidney: n = 1) were recruited, with 18 completing fluoroscopy screening. Deep inspiration BH for 17% (n = 3), inspiration BH for 39% (n = 8) and expiration BH for 44% (n = 8) were selected. The personalised technique showed improved reproducibility (mean 0.92 mm, SD 0.79) compared to the standard expiration BH approach (mean 1.79 mm, SD 1.49). Among the 16 patients who completed treatment, the mean BH time was 22.8 seconds (range 15–30 seconds), with a mean efficiency of 0.47 (SD 0.12) from 5–15 fractions. Inspiration BH treatments were most efficient. Efficiency improved with longer BH duration, irrespective of technique. Conclusion: Personalised BH technique selection can select the technique which enables optimal tumour position reproducibility and treatment efficiency. This screening process enables selection of BH technique tailored to individual patient performance. Enhancing equity and confidence in breath hold radiotherapy: Outcomes of the INSPIRE‐RT mobile application Rory Hartley 1 , Toby Lowe 1 , Maiko Crispin 1 , Susan Carroll 1,2 , Gillian Lamoury 1,2 1 Northern Sydney Cancer Centre, Sydney, Australia, 2 The University of Sydney, Sydney, Australia Introduction: Deep inspiration breath hold (DIBH) substantially reduces cardiac and pulmonary dose for left‐sided breast cancer patients. 1,2 However, patients from culturally and linguistically diverse (CALD) backgrounds often experience barriers to participation due to communication and coaching limitations. 3 INSPIRE‐RT, a multilingual mobile application, was developed to overcome these barriers, standardise breath hold education and improve patient preparedness. Methods: INSPIRE‐RT was co‐designed with a consumer advisory group and implemented in our department in 2024. The app provides translated video coaching, visual feedback and educational modules for DIBH and expiratory breath hold. Data was collected on patient usage and staff feedback. Comparative data was also obtained from English‐speaking patients pre‐CT, pre‐ and post‐implementation. Results: All CALD patients successfully completed their DIBH (breast) and expiratory breath hold (abdominal) treatment courses (previously 0%). Among English‐speaking patients, preliminary results indicate a substantial decrease in pre‐CT anxiety as well as a significant reduction in patients seeking additional training. Staff reported improved workflow efficiency and patient comprehension. Conclusion: INSPIRE‐RT has improved patient confidence, access and departmental efficiency while reducing interpreter reliance. It demonstrates how consumer‐driven digital innovation can enhance equity and standardisation in radiotherapy delivery. Future developments aim to extend the platform to additional treatment sites and treatment related services. References 1. Darby SC, Ewertz M, McGale P, et al. Risk of ischemic heart disease in women after radiotherapy for breast cancer. New Engl J Med 2013;368(11):987–98. https://doi.org/10.1056/NEJMoa1209825 2. Lu HM, Bartlett GK, Chen JJ, et al. Clinical and dosimetric benefits of deep inspiration breath hold in breast radiotherapy: a systematic review. Pract Radiat Oncol 2022;12(3):e186–96. https://doi.org/10.1016/j.prro.2021.11.006 3. Shah S, Bolderston A, Kerr L. Culturally and linguistically diverse (CALD) patients in radiation therapy: barriers, challenges and opportunities. J Med Imaging Radiat Oncol 2021;65(5):595–603. https://doi.org/10.1111/1754‐9485.13255 Adapting breath hold coaching instructions when listening isn’t an option Melissa Neal 1 , Onno Kamst 1 , Charlotte Skidmore 1 , Katheryn Churcher 1 , Madeline Downes 1 1 Sunshine Coast University Hospital, Birtinya, Australia Introduction: Managing respiratory motion is of critical importance in stereotactic body radiation therapy as precision is required to safely deliver ablative doses while sparing surrounding organs. Audible coaching is commonly used to cue breath‐holds at appropriate timepoints. For deaf patients, audible instructions are not suitable, requiring adaption. Case Presentation: A profoundly deaf patient required motion managed abdominal stereotactic body radiation therapy for pancreatic cancer. The motion management system incorporated visual feedback on position but relied on audible coaching. The patient was engaged in developing a suitable adaptation to achieve reproducible breath holds. The patient has consented to this case presentation including identifiable footage. Management/Outcome: Prior to simulation a small project team worked with the patient on options for visual respiratory coaching. A system was developed that allowed the patient to see one screen showing custom visual cues and another showing positional feedback. Additional time was allocated to practice at the first treatment, aided by an Auslan interpreter and a project radiation therapist. Standard imaging and delivery‐reliability metrics indicated reproducible breath‐holds were achieved. An interpreter was not required for subsequent treatments and the course was delivered as prescribed. Discussion: This case demonstrates that reasonable adaptations can maintain accuracy and safety in radiotherapy for patients with sensory impairments. Listening to patient needs, adapting workflows and discovering innovative solutions ensured best‐practice delivery. This approach aligns with the ASMIRT 2026 theme, ‘Navigate the Wilderness: Listen, Adapt, and Discover’ and may inform future inclusive practices in radiotherapy. Improved breast DIBH simulation efficiency with a take‐home wireless respiration belt coaching system Daniel Sapkaroski 1,2 , Anelyn Chui 1 1 Peter MacCallum Cancer Centre, Melbourne, Australia, 2 RMIT University, Melbourne, Australia Introduction: Breath hold techniques such as deep inspiration breath hold (DIBH) reduce radiation dose to organs at risk but require patient training and reproducibility. 1 Conventional workflows rely on verbal instruction at simulation. 2 This pilot study evaluated whether a home‐based wireless respiration belt coaching system (RBC) improves simulation efficiency and patient preparedness compared with standard of care. Methods: 42 patients receiving radiation therapy for breast cancer in DIBH were enrolled (21 with RBC coaching, 21 with standard of care verbal coaching). RBC coaching used a take home Bluetooth (Vernier) respiration belt 3 and tablet providing real‐time visual feedback for 1–2 weeks prior to CT simulation (CT‐sim). Primary objective: CT‐Sim duration compared using independent‐samples t‐test, secondary measures were treatment setup and image‐guided radiation therapy times. Patient acceptability was assessed using a Likert‐scale survey post‐simulation. Results: Mean CT‐sim time for RBC patients was 31.2 ± 11.4 minutes, significantly shorter than the standard of care group 58.3 ± 13.6 minutes (p < 0.001, Cohen's d = 2.16). No significant differences were found in imaging or treatment delivery times between groups (p > 0.28). RBC survey respondents (n = 20): 85% felt moderately or very confident performing breath hold at simulation, 66% found the RBC system very or extremely easy to use, and all respondents would recommend the device. Conclusion: Home‐based RBC decreased breast CT‐sim times and was highly acceptable to patients. The RBC intervention, by providing a method for guided self‐learning, may streamline simulation workflows and improve patient engagement in gated radiotherapy. References 1. Reitz D, Walter F, Schönecker S, et al. Stability and reproducibility of 6013 deep inspiration breath‐holds in left‐sided breast cancer. Radiat Oncol 2020;15(1):121. 2. Oonsiri P, Wisetrinthong M, Chitnok M, Saksornchai K, Suriyapee S. An effective patient training for deep inspiration breath hold technique of left‐sided breast on computed tomography simulation procedure at King Chulalongkorn Memorial Hospital. Radiat Oncol J 2019;37(3):201–6. 3. Vernier Science Education. Go Direct Respiration Belt [Internet]. Beaverton (OR): Vernier Science Education. Available at https://www.vernier.com/product/go‐direct‐respiration‐belt/ SBRT to six lesions in the lung – Don't hold your breath Mikayla Wald 1 , Meg Kirkilis 1 , Muhammad Ali 1 1 Peter MacCallum Cancer Centre, Melbourne, Australia Introduction: Emerging evidence highlights the expanding role of stereotactic body radiotherapy (SBRT) in oligometastatic disease. 1 However, limited guidance exists on patient considerations and motion management (MM) when treating multiple metastases within a single organ. This case highlights the role of effective MM and patient advocacy in safely delivering SBRT to six lung metastases. Case Presentation: A 57‐year‐old female with a history of nasopharyngeal carcinoma presented with six lung metastases (five right, one left). She declined systemic therapy, leaving options of observation, palliative radiotherapy or SBRT. Management: Lung dose constraints and motion of the inferior lesions were key concerns, with several MM techniques considered. Inspiration breath hold (IBH) was recommended for reproducibility and maintaining lung volume. Pre‐CT mock‐up proved IBH inconsistent (>1 cm variation). 4DCT showed motion up to 2 cm; exhale phase‐gating reduced motion, but decreased lung volume. The patient was re‐coached in IBH and encouraged to practise overnight. A repeat mock‐up showed stable IBH with <3 mm variation. IBH MM was used for CT planning. Outcome: IBH proved stable and achievable through treatment and was verified on pre‐treatment imaging. All six lesions were treated successfully over 3 weeks using five isocentres (Fig. 1). The patient reported mild pneumonitis, resolving within 3 months. One‐month follow‐up imaging demonstrated ~50% tumour reduction and no new disease. Discussion: This case demonstrates the challenges faced when delivering SBRT to multiple metastases. It highlights the necessity of working with patients, adapting techniques and learning through collaborative problem‐solving. Strong patient advocacy and engagement were central to achieving optimal outcomes. Reference 1. Palma DA, Olson R, Harrow S, et al. Stereotactic ablative radiotherapy for the comprehensive treatment of oligometastatic cancers: long‐term results of the SABR‐COMET Phase II Randomized Trial. J Clin Oncol 2020;38(25):2830–8. Friday 27 March, 11:00 AM – 12:30 PM Navigating Practice Improvement (RT) It's not rocket science, it's only nuclear physics – Enhancing radiation therapist engagement in audits Kate Francis 1 1 Australian Radiation Protection and Nuclear Safety Agency, Sydney, Australia Dosimetry audits are essential for safeguarding patient safety and ensuring quality assurance in radiation therapy. Yet, for many radiation therapists (RTs), audits can feel repetitive and time consuming: “Another audit? Didn’t we just have one?” RTs play a pivotal role in ensuring protocol accuracy, treatment delivery and patient safety – making their engagement essential to meaningful audit outcomes. The Australian Clinical Dosimetry Service (ACDS) receives numerous comments and feedback from our clients, which often highlight the stress and workload that falls upon RTs for dosimetry audits and field trials. Lack of enthusiasm may stem from the limited visibility into the physics behind dose measurements and how these influence planning system decisions. This presentation aims to demystify dosimetry audits by: showcasing key measurement equipment explaining audit metrics in accessible terms, and clarifying how audit results directly inform clinical decision‐making. By increasing transparency and clinical relevance, RTs can better understand the value of audits and feel more empowered in their role. In line with the ASMIRT 2026 theme, ‘Navigate the Wilderness: Listen, Adapt, and Discover’, the ACDS has listened to RT feedback, adapted its approach to better reflect clinical practice, and invites RTs to discover their vital role in radiation safety through deeper engagement with audit processes. Form meets function: Improving radiation comfort and accuracy with personalised cushions Mark Johnstone 1 1 Alfred Health Radiation Oncology, Melbourne, Australia Introduction: With the emergence of surface guided radiation therapy (SGRT) systems, a future of maskless treatments for patients with head and neck cancer is in sight. This is of particular interest for patients who cannot manage thermoplastic masks, including those who experience mask‐related anxiety or claustrophobia. When used in conjunction with SGRT, personalised cushions (Moldcare – ALCARE, Japan) may provide superior stabilisation and greater comfort to patients when compared with standardised neck supports. Methods: Non‐clinical staff were invited to participate in a blinded comparative study. Across 10 simulation sessions, participants spent 15 minutes on the treatment couch supported alternately by either a personalised cushion or standardised neck support. Stabilisation effectiveness was determined via monitoring from SGRT. Participants were asked to complete questionnaires using the Likert scale, with questions pertaining to comfort. Results: Analysis of SGRT data found that the use of personalised cushions reduced the mean variation in pitch and rotational position compared with standardised neck supports, while variation of roll and translational position were portrayed to be comparable with both supports. Analysis of participant questionnaires demonstrated a correlation towards a greater feeling of comfort and support when using personalised cushions compared to standardised neck supports. Conclusion: When used in conjunction with SGRT, personalised cushions have demonstrated greater stabilisation and increased reportable comfort than standardised neck supports. These results support the feasibility of maskless treatment for patients receiving treatment to the head and neck without compromising patient care particularly where traditional thermoplastic masks are not tolerated. Disclosure: Items were provided by NL Tech, the Australian supplier for ALCARE, for the purposes of this research. Advancing reirradiation practice: Challenges, innovations and clinical integration Catherine Laferlita 1,2 , Katrina Woodford 1,2,3 , Kenton Thompson 1,2 , Nick Hardcastle 2,4,5 1 Department of Radiation Therapy Services, Peter MacCallum Cancer Centre, Melbourne, Australia, 2 Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia, 3 Monash University, Melbourne, Australia, 4 The University of Wollongong, Wollongong, Australia, 5 Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Australia Advances in anticancer treatments have improved patient survival, leading to an increasing number of patients requiring additional radiation therapy to the same or adjacent anatomical sites – a practice known as reirradiation (reRT). 1 While technological advancements in treatment planning and delivery have enhanced the feasibility of reRT, the benefits must be carefully balanced against the potential for adverse events. This presentation will review recent developments in reRT, focussing on technical innovations, clinical decision‐making frameworks and emerging consensus recommendations from collaborative groups such as the European Society of Radiotherapy and Oncology and the Reirradiation Collaborative Group. The presentation will explore the importance of establishing a dedicated planning pathway for reRT patients. A key focus will be the role of deformable image registration, associated deformable dose mapping and the critical need for biological dose accumulation to improve dose accuracy. By highlighting current evidence and collaborative initiatives, this session aims to equip radiation therapists, who are a key member of the interdisciplinary team, with practical strategies to safely and effectively advance reRT in their clinical practice. Reference 1. Andratschke N, Willmann J, Appelt A, et al. European Society for Radiotherapy and Oncology and European Organisation for Research and Treatment of Cancer consensus on re‐irradiation: definition, reporting, and clinical decision making. Lancet Oncol 2022;23:e469–78. Optimising contralateral organs at risk in unilateral radiotherapy of tonsil cancer: A re‐optimisation exercise from TROG 12.01 Glen Osbourne 1 , Nadia Walsh 1 , Aimee Devlin 2 , June Corry 3,4 , Lachlan McDowell 1,2 1 Peter MacCallum Cancer Centre, Melbourne, Australia, 2 Princess Alexandra Hospital, Brisbane, Australia, 3 GenesisCare, St Vincent's Hospital, Melbourne, Australia, 4 The University of Melbourne, Melbourne, Australia Introduction: Unilateral radiotherapy (URT) is an effective treatment strategy in selected patients with lateralised tonsil cancer, 1 however, there are no established guidelines for URT planning, potentially resulting in suboptimal optimisation of contralateral and midline organs at risk (OAR). The aim of this study was to establish optimal goals for OAR in URT planning. Methods: Treatment plan data for 22/26 available patients treated with URT on TROG 12.01 were imported into the treatment planning system (Eclipse v16.01, Varian Medical Systems, Palo Alto, USA). For each case, a volumetric modulated arc therapy (VMAT) plan was optimised with the aim of maximal contralateral and midline OAR sparing, without compromising target coverage or exceeding clinically acceptable doses to the mandible, brainstem or spinal cord. These plans were peer‐reviewed by three experienced radiation therapists and two experienced radiation oncologists. Metrics for targets and OAR were compared with the originally delivered plan using a Wilcoxon signed rank test. Results: Re‐optimised plans were all protocol‐compliant for target coverage. They demonstrated both clinically and statistically significant reductions (all p < 0.001) in mean doses to the pharyngeal constrictors (48.5 Gy vs 37.4 Gy), contralateral submandibular gland (14.9 Gy vs 6.7 Gy), contralateral parotid gland (9.2 Gy vs 4.9 Gy), oral cavity (39.5 Gy vs 35.9 Gy) and glottis (21.5 Gy vs 9.8 Gy). Conclusions: Significant midline and contralateral OAR sparing can be achieved while maintaining target coverage, reducing the risk of acute and late toxicities. These results provide guidance on achievable OAR constraints for URT planning. Reference 1. Tsai CJ, Galloway TJ, Margalit DN, et al. Ipsilateral radiation for squamous cell carcinoma of the tonsil: American Radium Society appropriate use criteria executive summary. Head Neck 2021;43(1):392‐406. Pelvic tilt, is the equipment the solution? A study of immobilisation devices on pelvic tilt Naafi'ah Binte Peer Mohamed 1 , Jeannie Lin YiXin 1 1 National Cancer Centre Singapore, Singapore Introduction: The gynaecological radiotherapy region often extends from the 4th and/or 5th lumbar vertebrae to the sacrum. 1 Hence, accurate pelvic tilt is important to ensure both primary target and pelvic lymph nodes are precise. Out‐of‐tolerance pelvic tilt could result in inaccurate treatment. Hence, multiple re‐setups with intrafraction X‐rays are needed, 2 leading to extended treatment time and patient apprehension. Even with the use of immobilisation devices, achieving an accurate pelvic tilt is a daily struggle. 3 This study aims to assess if reproducibility of pelvic tilt is related to the immobilisation used. Methods: A retrospective cross‐sectional study was conducted where patients were treated using three setups: Knee Rest (KR); Knee Rest with Foot Support (KR+FS); and Knee Rest with Foot Support and Arms Pp (KR+FS+ArmsUp). The first setup image acquired as cone beam CT (CBCT) or orthogonal kilovoltage (kV) images were reviewed. Results: 475 kV and 291 CBCT images were analysed via one‐way ANOVA with p‐value of < 0.05 being statistically significant. Among the three setups, for CBCT, statistically significant difference was found between KR+FS+ArmsUp and KR (p < 0.05) and KR+FS+ArmsUp and KR+FS (p < 0.05), but no difference was found between KR and KR+FS. Conclusion: This study proves immobilisation is associated with pelvic tilt and KR+FS+ArmsUp is the superior setup. However, KR+FS+ArmsUp requires additional tattoos and raised arms, which can be uncomfortable and tiring for patients. Solutions that could solve this issue of pelvic tilt while prioritising patient comfort must be sought to reduce extended treatment time, multiple imaging exposures and patient apprehension. References 1. Jo JH, Lee JW, Seol KH. Assessing the adequacy of traditional vertebral landmarks as upper border of whole pelvic radiotherapy field for stage IB2‐IIB cervical cancer. Cancers 2024;16(15):2743. https://doi.org/10.3390/cancers16152743 2. Tsujii K, Ueda Y, Isono M, et al. Dosimetric impact of rotational setup errors in volumetric modulated arc therapy for postoperative cervical cancer. J Radiat Res 2021;62(4):688–98. 3. Prasad S, Bell LJ, Zwan B, et al. Comparing immobilisation devices in gynaecological external beam radiotherapy: improving inter‐fraction reproducibility of pelvic tilt. J Med Radiat Sci 2024;71(4):529–39. https://doi.org/10.1002/jmrs.804 Functional imaging for organ at risk sparing in patients with glioma Li Wen Yeo 1 , John Ryan 2 1 National University Cancer Institute, Singapore, 2 Monash University, Melbourne, Australia Introduction: Beyond improving target delineation, functional imaging holds significant promise in identifying critical functional brain regions, enabling a more personalised approach to radiotherapy planning, where organs at risk can be spared more effectively, potentially preserving neurocognitive function and quality of life in patients with glioma. 1,2 This systematic review aims to identify the role of functional imaging in preserving neurocognitive function in radiotherapy patients with glioma. Methods: A qualitative review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta‐analyses (PRISMA) guidelines. Searches were performed in Scopus, Medline and EMBASE using medical subject headings and keywords related to glioma, functional imaging, cognition and radiotherapy. Only English‐language publications were included. The Critical Appraisal Skills Programme (CASP) checklist was used to evaluate the quality of the studies. Results: Five studies published between 2019 and 2023 were included in the review. The studies included retrospective cohort studies (n = 2), a pilot study (n = 1), a cross‐sectional study (n = 1) and a theoretical study (n = 1). Functional imaging was shown to reduce the dose to cognitive areas and potentially protect important cognitive functions. Conclusion: Functional imaging identifies critical cognitive regions in the brain and guides radiation dose to avoid these vulnerable regions while maintaining therapeutic efficacy. Integrating functional imaging into treatment planning allows for individualised dose planning and potentially minimises the risk of cognitive impairment. This review sets the stage for future research to expand the benefit of functional imaging in glioma radiotherapy planning. References 1. Baker S, Logie N, Paulson K, Duimering A, Murtha A. Radiotherapy for brain tumors: current practice and future directions. Curr Cancer Ther Rev 2020;16(3):182–95. https://doi.org/10.2174/1573394715666181129105542 2. De Roeck L, Blommaert J, Dupont P, et al. Structural network hubs as potential organs at risk in glioma patients after radiation therapy. Int J Radiat Oncol Biol Phys 2025;122(3):631–42. https://doi.org/10.1016/j.ijrobp.2025.03.019 Friday 27 March, 11:00 AM – 12:30 PM Listening Across Professions (MI) Investigating factors influencing fatigue and radiographer performance in continuous shiftwork cycles Trevor Gillbard 1 , Dane Thompson 2 1 Redcliffe District Hospital, Redcliffe, Australia, 2 The Prince Charles Hospital, Chermside, Australia Introduction: Up to 20% of the global workforce perform shiftwork. 1 Shiftwork causes fatigue and increases the risk of accidents. Many studies demonstrate the effects of shiftwork on fatigue in other professions. 1,2,4‐6 Radiographers have been left in the wilderness on research investigating shiftwork fatigue. 2,3 This research aimed to better understand factors impacting on fatigue levels of radiographers who perform night shifts. Methods: All staff employed at two Australian metropolitan hospitals who had performed night shifts within the past year were invited to complete a custom‐made electronic survey. Quantitative survey responses were examined using a combination of descriptive and comparative statistics. An applied thematic analysis was used to examine qualitative findings from open‐ended questions. Results: Radiographers perceived roster patterns with 7‐night shifts, then 7 days off, to be less fatiguing and more sustainable. Fatiguing factors including being awake at night and longer shift lengths were perceived as significantly more fatiguing during the first 3 days of night shifts and the mean number of days taken to return to a normal sleep routine following night shifts was reported to be 3.2 days. Workload was rated as the factor that caused the highest levels of fatigue throughout a night shift roster. The majority of participants expressed that organisation level changes are needed to reduce fatigue levels. Conclusion: Organisation level strategies to: 1) reduce workloads; and 2) enable rosters with 7‐night shifts followed by 7 days off, are needed to help radiographers effectively manage fatigue levels. References 1. Ferri P, Guadi M, Marcheselli L, et al. The impact of shift work on the psychological and physical health of nurses in a general hospital: a comparison between rotating night shifts and day shifts. Risk Manag Healthc Policy 2016;9:203–11. 2. Elliott J, Hodges C, Boots M, et al. Mixed shift rotations, sleep, burnout and well‐being in professions similar to radiographers: a systematic review. Radiography 2024;30(4):1194–200. 3. Elliott J, Williamson K. The radiology impact of healthcare errors during shift work. Radiography 2020;26(3):248–53. 4. Lancman BM. Night shift fatigue among anaesthesia trainees at a major metropolitan teaching hospital. Anaesth Intensive Care 2016;44(3):364–70. 5. Patterson PD, Runyon MS, Higgins JS, et al. Shorter versus longer shift durations to mitigate fatigue and fatigue‐related risks in emergency medical services personnel and related shift workers: a systematic review. Prehosp Emerg Care 2018;22(Suppl 1):28–36. 6. Jackson EJ, Moreton A. Safety during night shifts: a cross‐sectional survey of junior doctors’ preparation and practice. BMJ Open 2013;3(9):e003567. Securing an invitation to the party: A phenomenological study on radiographers’ experiences of interprofessional collaboration Elizabeth Jones 1 , John McInerney 1 , Caroline Wright 1 1 Monash University, Clayton, Australia Introduction: The multi‐disciplinary nature of health care requires effective interprofessional collaborative practice (ICP). 1 Radiographers are required by the Medical Radiation Practice Board of Australia to ‘collaborate with other health practitioners’, 2 emphasising the importance of ICP in practice. Fostering ICP is not only a professional obligation but crucial for optimising patient outcomes, safety, service efficiency and practitioner wellbeing. The interProfessional Activity Classification Tool (interPACT) assists in examining the nature of ICP through defining four aspects: teamwork, collaboration, coordination and networking. 3 This study aimed to explore radiographers’ experiences and perceptions of ICP. Methods: This qualitative interpretive phenomenological study recruited participants through mailout distribution to Australian Society of Medical Imaging and Radiation Therapy members. Semi‐structured interviews were conducted via Zoom. Guided by interPACT as the theoretical framework, inductive thematic analysis generated initial codes and identified themes. 3 Results: Nine radiographers were interviewed. Three overarching themes emerged: 1) A radiographer's need to be collaborative; 2) Securing an invitation to the party; and 3) Shaping collaboration through resources and processes. This presentation focusses on Theme 2: Securing an invitation to the party (radiographers' self‐perception as outsiders) with related subthemes: What do radiographers bring to the table?; Navigating boundaries between groups; Showing up to the party; and Creating a seat at the table. Conclusion: Respondents suggest effective ICP requires clearer role definitions, inclusive team culture and strategies for radiographers to actively advocate and model professional expertise. Future research could apply observational methods to examine radiographers’ contributions in ICP and capture other professionals’ perspectives of radiographers’ roles and their perceptions of ICP. References 1. Framework for action on interprofessional education & collaborative practice. World Health Organization; 2010. Available at https://www.who.int/publications/i/item/framework‐for‐action‐on‐interprofessional‐education‐collaborative‐practice 2. Professional Capabilities. Medical Radiation Practice Board of Australia. 2020. Available at https://www.medicalradiationpracticeboard.gov.au/Registration‐Standards/Professional‐Capabilities.aspx 3. Xyrichis A, Reeves S, Zwarenstein M. Examining the nature of interprofessional practice: an initial framework validation and creation of the InterProfessional Activity Classification Tool (InterPACT). J Interprof Care 2018;32(4):416–25. https://doi.org/10.1080/13561820.2017.1408576 “Not been seen as an important part of the process” – Allied professional residential aged care facility imaging Chandra Makanjee 1 1 The University of Canberra, Bruce, Australia Introduction: Mobile X‐ray and ultrasound services are essential for delivering health care within residential aged care facilities (RACFs). 1 The RACF workforce caring for older persons comprises allied health professionals, including nurses and physiotherapists. Notably, medical practitioners 2 and mobile imaging service providers are external to the RACF workforce. Therefore, interprofessional collaboration and effective communication are critical for coordinating care, making decisions and addressing ethical considerations related to imaging requests, examinations and outcomes. This study aimed to explore the lived experiences of allied health professionals involved in the delivery of mobile imaging services in RACFs. Method: A qualitative narrative approach was adopted, involving a convenience sample of allied health professionals – namely nurses, physiotherapists, radiographers and sonographers (n = 24). Data were collected through individual interviews conducted either online or face‐to‐face, using inductive, open‐ended questions and probes to elicit rich in‐depth insights into mobile imaging service delivery. A hybrid systematic thematic analysis was employed to interpret and analyse the data. 3 Results: Key themes emerged from the data interpretation and analyses: Assessment and monitoring prior to imaging, including the complex judgement required to escalate care; Flexible and adaptable referral pathways within structured institutional protocols; Navigating the multi‐layered systemic constraints, involving the balancing of resources and safety management; and Imaging structural logistics and handover challenges. Conclusion: This study underscores the importance of context‐sensitive imaging within the ethical and relational complexities of aged care. 4–6 It highlights the need for flexible and adaptive approaches to ensure accountable, justified, and socio‐economic responsive imaging practices within an integrated healthcare system. References 1. Dollard J, Edwards J, Yadav L, et al. Stakeholders' perspectives of mobile x‐ray services in support of healthcare‐in‐place in residential aged care facilities: a qualitative study. BMC Geriatr 2022;22(1):700. 2. Royal Commission into Aged Care Quality and Safety. Navigating the maze: an overview of Australia's current aged care system. Background Paper 1. Australia: Commonwealth of Australia; 2019. Available at https://agedcare.royalcommission.gov.au/sites/default/files/2019‐12/background‐paper‐1.pdf 3. Naeem M, Smith T, Thomas L. Thematic analysis and artificial intelligence: a step‐by‐step process for using ChatGPT in thematic analysis. Int J Qual Methods 2025;24:16094069251333886. 4. Garratt S, Dowling A, Manias E. Medication administration in aged care facilities: a mixed‐methods systematic review. J Adv Nurs 2025;81(2):621–40. https://doi.org/10.1111/jan.16318 5. Moilanen T, Kangasniemi M, Papinaho O, et al. Older people's perceived autonomy in residential care: an integrative review. Nursing Ethics 2021;28(3):414–34. 6. Sorensen MJ, von Recklinghausen FM, Fulton G, Burchard KW. Secondary overtriage: the burden of unnecessary interfacility transfers in a rural trauma system. JAMA Surgery 2013;148(8). Hard time getting X‐rays: Systemic benefits following introduction of on‐site X‐ray for prison health services Megan McKerrow 1 , Kasey Roberts 2 , Max Tomsia 1 1 Princess Alexandra Hospital, Brisbane, Australia, 2 Ipswich Hospital, Ipswich, Australia People in prison are some of Australia's most vulnerable in society, often coming from disadvantaged backgrounds and often suffering from poor health or chronic health conditions. 1 The number of incarcerated in Queensland is increasing at a rate that exceeds our population growth. 2 This also places increased pressure on our health services and emergency departments to manage their emergent and ongoing care. A major limitation to the provision of this care is the required escort and transport to access health services. Many of the patients transferred to a tertiary hospital following an acute injury require X‐rays, so in March 2021 an on‐site X‐ray service was established in several prison health services utilising retrofitted X‐ray equipment. Correctional services staff completed training to become X‐ray operators, while maintaining strong ties to a hospital radiography department for ongoing support from qualified radiographers. This has since grown to 36 X‐ray operators operating across eight sites – completing approximately 1600 exams annually. This presentation will review the roll‐out of this service and examine the benefits that have resulted, including reduced costs due to reduced patient transfers, reduced personal risk to patients and staff, a reduction in emergency department presentations, improved access to timely medical treatment, greater uptake in telehealth leading to a reduced failure to attend rate for outpatient appointments and, most importantly, improved access to health care for a disadvantaged group of Queenslanders. References 1. Australian Institute of Health and Welfare. 2023. The health of people in Australia's prisons 2022, About [Internet]. Available at https://www.aihw.gov.au/reports/prisoners/the‐health‐of‐people‐in‐australias‐prisons‐2022/contents/about 2. Australian Bureau of Statistics. Corrective Services, Australia, March Quarter 2025 | Australian Bureau of Statistics [Internet]. Available at https://www.abs.gov.au/statistics/people/crime‐and‐justice/corrective‐services‐australia/latest‐release Engaging with imaging to support a patient's journey: A comparative study between paramedics and radiography students Tashfia Lagno 1 , Nyein Aung 2 , Jenny Sim 1 , Daphne Flynn 2 , Nick Crawford 1 , Maryke Laubscher 2 1 Department of Medical Imaging and Radiation Sciences, Monash University, Melbourne, Australia, 2 Monash Design Health Collab, Monash University, Melbourne, Australia Introduction: Medical imaging underpins diagnosis, procedural guidance and patient monitoring across the care continuum. However, technologies and workflows optimised for fixed, resource‐rich hospital settings often misalign with the realities of pre‐hospital and mobile healthcare settings. This presentation explores how final‐year radiography students and MICA (Mobile Intensive Care Ambulance) flight paramedics engage with technology and imaging to support patient care, and how their perspectives can inform the design of adaptable imaging systems and curriculum. Methods: A qualitative approach using semi‐structured interviews with Monash University final‐year radiography students and MICA flight paramedics. Interviews were transcribed and thematically analysed using Braun and Clarke's framework. Ethical approval was obtained from the Monash University Human Research Ethics Committee (MUHREC #43165). Results: Comparative analysis identified patterns and contrasts across both groups regarding workflow, equipment usability, decision‐making and patient‐centred care. Radiography students prioritised patient comfort, clear communication, workflow and teamwork within structured and well‐resourced environments. In contrast, MICA flight paramedics described imaging as a rapid decision‐support tool constrained by space, weight and environmental conditions. They valued ruggedness, reliability and intuitive design rather than technological sophistication. Training shaped confidence with imaging. Students reported systematic education with feedback, whereas paramedics reported variable and ad hoc ultrasound training. Conclusion: Context dictates how practitioners define effective technology and imaging. Hospital‐based practice emphasises communication, consistency and predictable workflows. Pre‐hospital practice emphasises speed, simplicity and reliability that enable safe triage and timely transport. These findings support the co‐design of imaging systems that are durable, as well as patient‐centred curricula. Mapping the unmarked trail: Medical radiation practitioners and medication use in imaging Tim Suhr 1 1 Lumus Imaging, Melbourne, Australia Medication use within medical imaging presents a complex and often unclear landscape for medical radiation practitioners. While medication‐related responsibilities are referenced in professional capabilities, the practical application of these tasks is frequently hindered by inconsistent legislation, limited education and operational ambiguity. This presentation explores Lumus Imaging's journey to support medical radiation practitioners in navigating this space. Through continuous audit review, policy refinement, external consultation and the development of targeted governance tools, we have worked to clarify how medical radiation practitioners can safely and confidently participate in medication workflows within their scope of practice. This includes recognising medication risks, supporting authorised administration and contributing to patient safety through structured processes. The presentation reflects on the challenges of interpreting state‐based poisons legislation, addressing gaps in undergraduate training and embedding consistent practice across a national network. It offers practical insights into how governance can guide medical radiation practitioners through uncertainty, enabling them to meet professional expectations while maintaining safety and compliance. Friday 27 March, 1:30 PM – 3:00 PM Varian Award Session (RT) Evaluation of flattening‐filter‐free beams to reduce out‐of‐field dose in paediatric cranial radiation therapy Thu Dang 1 , Robyn Guidi 1 , Andrew Pullar 1 , Lucy Sim 1 , Catriona Hargrave 1,2 , Lisa Nissen 2,3 1 Princess Alexandra Hospital, Brisbane, Australia, 2 Queensland University of Technology, Brisbane, Australia, 3 The University of Queensland, Brisbane, Australia Introduction: Incidents of radiation‐induced secondary malignant neoplasm in paediatric radiation therapy have been reported at dose levels ≤0.1 Gy. 1‐3 Therefore, out‐of‐field dose is an important aspect of paediatric cancer survivorship. We aimed to compare flattened beams (FB) versus flattening‐filter‐free (FFF) beams and linear accelerator (linac) head design on out‐of‐field doses in paediatric cranial radiation therapy. Methods: Ethics approval was granted to compare clinical FB plans with retrospectively generated FFF plans. The clinical plan's prescription and beam geometry were maintained for each individual patient. Plans were delivered on the 5–10 mm wide multi‐leaf collimator linac (Varian Millennium TrueBeam) and 2.5–5 mm wide multi‐leaf collimator linac (Varian high‐definition TrueBeam) with children‐sized anthropomorphic phantoms. Out‐of‐field doses to radiosensitive organs and at 2.5 cm, 5 cm, 10 cm and 20 cm from the field edge were measured using radiochromic film. Results: FB and FFF plans for 11 paediatric patients (aged 2–14 years) had comparable plan quality metrics. Doses at 2.5–15 cm from the field edge were lowest with 10 FFF for most scenarios tested. At >15 cm, doses depended on beam geometry and the linac head design. For a coplanar beam arrangement, high‐definition TrueBeam increased out‐of‐field doses by >100% (0.38 Gy vs 0.17 Gy) compared to the Millennium TrueBeam. Conclusions: While out‐of‐field dose in paediatric cranial radiation therapy is influenced by beam arrangement, mode and energy, as well as linac head design, 10 FFF was found to produce clinically acceptable plans with more frequently lower out‐of‐field doses. References 1. Newhauser WD, Durante M. Assessing the risk of second malignancies after modern radiotherapy. Nat Rev Cancer 2011;11(6):438–48. 2. Kleinerman RA. Cancer risks following diagnostic and therapeutic radiation exposure in children. Pediatric Radiology 2006;36(2):121–5. 3. Firass Ghareeb, et al. Influence of extrafocal dose in the out‐of‐field dose distribution in a paediatric anthropomorphic phantom, irradiated with a FFF beam and a 120 HD MLC ‐ Monte Carlo simulations and gafchromic EBT3 dose distribution. Physica Medica 2018;52:57. Improving intrafraction treatment accuracy for SABR spine using triggered kV imaging on the TrueBeam platform Stephen Kirrane 1 1 Icon Cancer Centre, Gold Coast, Australia Introduction: Precision is paramount in the delivery of spine stereotactic ablative radiotherapy (SABR) due to high radiation doses with steep gradients adjacent to the spinal cord. A major challenge is the lack of real‐time intrafraction motion monitoring. To address this, the use of triggered kilovoltage (kV) imaging on the Varian TrueBeam platform was evaluated to assess feasibility, safety and impact on workflow. Methods: Triggered kV imaging acquires multiple images at defined gantry intervals during VMAT delivery, providing real‐time motion checkpoints with minimal workflow disruption. Image‐guided radiation therapy structures of the treated vertebra, including 1 mm expansion structures, were created on the planning CT and projected onto the triggered images for visual assessment. Initial patient cohorts followed full SABR imaging workflows including setup, verification and post‐treatment cone beam CTs (CBCT). Any displacement beyond tolerance prompted treatment interruption and verification CBCT. Results: Triggered kV image quality was evaluated and correlated with CBCT findings, reliably detecting any motion exceeding 1 mm with high visual clarity. Only one treatment required intervention due to detected displacement. These analyses enabled streamlined workflows, safely omitting mid‐ or post‐CBCTs when triggered images confirmed motion within 1 mm tolerance. Treatment times were reduced by 10 minutes, and imaging dose decreased substantially (kV <1 cGy vs CBCT ~10–20 cGy). Conclusions: Triggered kV imaging offers an accurate and reliable, low‐dose, real‐time solution for intrafraction motion monitoring in spine SABR, improving efficiency and confidence while maintaining precision and safety. The success of this workflow has now been extended to SABR pelvic bone treatment. Seeing the bigger picture: Prostate SABR treatment dosimetric accuracy evaluation using high definition CBCT Alice Riches 1 1 Alfred Health Radiation Oncology, Melbourne, Australia Introduction: High‐definition cone beam CT (CBCT) (HyperSight, by Varian Medical Systems) is an Australian‐first linac‐based installation in this department. High‐definition CBCT provides improved soft‐tissue delineation on a larger panel and facilitates calculation on the CBCT. It provides daily image verification for departmental prostate stereotactic ablative body radiotherapy (SABR) treatment. This retrospective study evaluates actual versus planned dose delivered to rectum and bladder in prostate SABR patients by re‐calculating treatment plans on each fraction's high‐definition CBCTs acquired prior to treatment. Method: 10 patients undergoing prostate SABR were included in this study. Radiation therapists acquired a high‐definition CBCT prior to treatment every fraction to assess target volume coverage and organ at risk sparing, as per protocol. The treatment plan was retrospectively recalculated using each fraction's high‐definition CBCT to compare planned and delivered bladder and rectum doses. The organs at risk were initially delineated by AI auto‐segmentation (M‐Vision, Finland) and cross‐checked by a radiation oncology registrar to ensure clinical appropriateness for re‐calculation. Results: Bladder and rectum exhibited inter‐fraction variability typically observed in prostate SABR treatment. Accordingly, there were differences in planned versus actual doses received to bladder and rectum. However, these differences when considered as part of the overall treatment course were considered clinically insignificant by the radiation oncologist. Conclusion: High‐definition CBCT allows for comparison of planned versus delivered doses to organs at risk in prostate SABR patients. This study demonstrated non‐clinically significant variations in dose when bladder and bowel filling was different to planned. Future workflows could incorporate routine offline‐adaptive assessment including target coverage evaluation. Clinical implementation of a high‐definition advanced imaging system on a linear accelerator: An Australian first Alice Riches 1 1 Alfred Health Radiation Oncology, Melbourne, Australia The high‐definition advanced imaging system (HDAIS), integrated with cone beam CT (CBCT), enables rapid image acquisition, accurate dose calculations and enhanced diagnostic image quality. A key feature is metal artefact reduction, allowing radiation therapists to make reliable daily treatment decisions. This presentation outlines the implementation of HDAIS (Hyper Sight – Varian Medical Systems) on the linear accelerator, sharing user experiences across various tumour streams. The team reflects on successful strategies, challenges, integration into clinical routines, and how the system has improved workflow efficiency and decision‐making, while reducing patient time on the treatment couch. The decision to implement HDAIS was driven by its superior image quality and field of view, offering CT‐comparable quality. The extended field of view on kV imaging, with a reconstruction capacity of up to 70 cm, allows better imaging adjustments, particularly for larger patients. Collaboration between radiation therapists and medical physicists was essential to optimise CBCT settings, ensuring high‐quality imaging while adhering to ALARA (as low as reasonably achievable) principles. Routine clinical use of HDAIS has led to more confident and precise decision‐making, contributing to improved treatment delivery. Additionally, the ability to retrospectively contour and recalculate treatment plans using HDAIS CBCT scans opens opportunities to compare actual delivered therapy against planned treatment through improved delineation of target volumes and organs at risk. This supports continuous evaluation and refinement of radiation therapy practices, ultimately enhancing patient care and outcomes. Friday 27 March, 1:30 PM – 3:00 PM Adapting Safe Practice Enhancing safety in intravenous contrast practice: A multi‐disciplinary initiative to improve oversight and patient management Dana Jackson 1,2 1 Monash Health, Clayton, Australia, 2 Monash University, Clayton, Australia Introduction: Historically, adverse reactions to intravenous contrast media at our service were documented via RiskMan only. However, this process lacked transparency and direct utility for radiology clinicians, limiting oversight, trend identification and safe planning for subsequent contrast studies. Methods: In mid 2024, a Contrast Safety Committee was formed, comprising radiologists, radiographers, a quality manager and an allergist. Two baseline assessments were conducted: 1) an audit of all contrast reactions in 2023 revealed inconsistent, incomplete or poor‐quality documentation; and 2) a staff survey found limited knowledge in recognising reactions and following safety protocols. A standardised signs and symptoms checklist was developed for immediate use when a reaction occurs. This checklist is scanned into the radiology information system and used by radiologists to guide contrast decisions for future imaging. Targeted continuing professional development sessions were delivered to radiographers, focussing on early recognition of reactions and patient deterioration. Patients experiencing a reaction now receive personalised information for subsequent providers Results: Post‐implementation, documentation completeness and clarity have improved, and staff confidence in recognising reactions is increasing (via post‐CPD feedback). Radiologists report better access to relevant reaction histories for improved decision support. Patients appreciate receiving tangible documentation of their event. Conclusion: This multi‐disciplinary, governance driven initiative demonstrates that structured documentation, embedded into the radiology information system, combined with staff education and patient communication, can strengthen the safety framework for IV contrast in medical imaging. It provides a scalable model for other services aiming to improve contrast reaction management and patient continuity of care. Adrenaline use in medical radiation sciences Alan Malbon 1 1 The Australian Society of Medical Imaging and Radiation Therapy, Melbourne, Australia In 2025, the Medical Radiation Practice Board of Australia (MRPBA) released the latest version of their Professional Capabilities for Medical Radiation Practitioners document, which included updates to the potential prescription, supply and administration of scheduled medicines in medical radiation science. The Australian Society of Medical Imaging and Radiation Therapy (ASMIRT) has been in ongoing dialogue with the MRPBA to discuss these recommendations to ascertain the viability of a project which supports and endorses prescribing, the supply and administration of scheduled medicines pertaining directly to medical radiation science. In June 2023, ASMIRT commissioned a national survey regarding the prescription, supply and administration of scheduled medicines in medical radiation science and from March 2026, the MRPBA's professional capabilities document will include anaphylaxis training and the use of adrenaline as a mandatory requirement. This presentation will outline the findings of the National Survey of Scheduled Medicines in Medical Radiation Science pertaining to anaphylaxis. It will detail Australian state and territory health departments’ legislation and regulation. The question of how this initiative will affect medical radiation practitioners’ professional indemnity insurance will also be examined. Detecting contrast extravasation in patients with richly pigmented skin: Addressing clinical gaps Sharon Ponniah 1 , Luke Barclay 2 1 St Vincent's Hospital Melbourne, Fitzroy, Australia, 2 The University of Canberra, Bruce, Australia Contrast media extravasation (CME), the accidental leakage of contrast media from the blood vessels into surrounding tissues, is a recognised complication during contrast enhanced medical imaging examinations. CME can cause pain and long‐term skin injuries such as necrosis or compartment syndrome. 1 Standard practice relies on detection of erythema and swelling through visualisation and palpation. 1 However, this is less apparent in richly pigmented skin, delaying detection, intervention and treatment. As skin of colour is biologically, functionally and structurally different, 2 CME is often only detected after a lack of contrast visualisation (following unnecessary radiation exposure), patient‐reported pain or significant palpable swelling from large volume extravasation. This presentation will discuss challenges and limitations of timely detection of contrast extravasation in patients with richly pigmented skin and identify strategies to improve clinical assessment across diverse populations. Patients with richly pigmented skin are likely to endure longer detection intervals compared to those with lighter skin tones due to healthcare professionals lack of confidence in assessing skin of colour. 3 Assessment protocols that rely on visual identification inadequately detect contrast extravasation in patients with richly pigmented skin, increasing risk for adverse outcomes. Using available and emerging technologies, proactive patient questioning and targeted staff training in skin tone‐inclusive assessment can enhance early detection and reduce adverse outcomes. References 1. Roditi G, Khan N, van der Molen AJ, et al. Intravenous contrast medium extravasation: systematic review and updated ESUR Contrast Media Safety Committee Guidelines. Eur Radiol 2022;32(5). 2. Rodrigues M. The importance of skin of colour dermatology in the primary care setting in Australia. Aust J Gen Pract 2023;52(10):665–7. 3. Harrison J. A scoping review exploring the confidence of healthcare professionals in assessing all skin tones. Br Paramed J 2023;8(2):18–28. Reframing documentation of contrast hypersensitivity reactions: A socio‐ecological scoping review Clare Singh 1 , Kelly Spuur 1 , Pauletta Irwin 1 1 Charles Sturt University, Wagga Wagga, Australia Introduction: Accurate documentation of contrast hypersensitivity reactions is critical for ensuring patient safety and management. Incomplete or inaccurate documentation can lead to withholding of contrast, unnecessary pre‐medication, increased anxiety for both patient and practitioner and increased healthcare cost. 1 This scoping review explores factors influencing documentation quality in contrast hypersensitivity, applying Bronfenbrenner's adapted socio‐ecological model. Method: A scoping review was undertaken following the Arksey and O’Malley framework, adapted for a socio‐ecological perspective. Searches of Ovid, Medline, SCOPUS, ProQuest and CINAHL Plus (2000‐present) identified 673 publications. Seven articles met the inclusion criteria. Data were coded in NVivo and mapped across Bronfenbrenner's micro, meso, exo, macro and chrono levels. Results: Challenges to documentation quality were evident across all system levels. At the micro level, limited patient knowledge and inconsistent documentation practices reduced information accuracy. At the meso and macro levels, fragmented frameworks, divergent terminology and lack of interoperability between the radiology information system and electronic medical records systems hindered accurate communication of contrast hypersensitivity reactions. 2 Chrono level analysis illustrated that historical hypersensitivity reactions as a result of ionic contrast media continue to influence decision making, despite low relevance. Conclusion: This is the first review to apply a socio‐ecological lens to contrast hypersensitivity documentation. Findings suggest the need for interprofessional education to establish a shared understanding of required information, consistent nomenclature and debunking of ‘contrast allergy’ myths. 3 Multiple systemic factors undermine documentation accuracy. This review provides a foundation for further research and an interprofessional approach to improve practice and patient safety. References 1. Boehm I. Three important points on the documentation of contrast hypersensitivity reactions to improve contrast medium safety. J Am Coll Radiol 2020;17(2):207. 2. Deng F, Li MD, Wong A, et al. Quality of documentation of contrast agent allergies in electronic health records. J Am Coll Radiol 2019;16(8):1027–35. 3. Wulf NR, Schmitz J, Choi A, Kapusnik‐Uner J. Iodine allergy: common misperceptions. Am J Health Syst Pharm 2021;78(9):781–93. Variation in contrast hypersensitivity practice guidelines: A global comparison Clare Singh 1 , Kelly Spuur 1 , Pauletta Irwin 1 1 Charles Sturt University, Wagga Wagga, Australia Introduction: Contrast hypersensitivity is a relatively uncommon yet clinically significant complication of contrast media administration. 1 Despite their importance, global contrast safety practice guidelines differ markedly in terminology, risk stratification, premedication protocols, follow‐up and documentation expectations. This creates uncertainty around best practice for not only medical radiation practitioners and radiologists, but for all health professionals involved in managing or documenting a current or past contrast hypersensitivity reaction. Methods: This comparative content analysis reviews clinical guidelines from Australia, Europe, North America, Asia and other regions, focussing on recommendations for prevention, risk stratification and management of contrast hypersensitivity reactions. The analysis will identify areas of consensus and disagreement, including the variation in nomenclature. Results: Preliminary analysis indicates limited consensus and inconsistent terminology. Such variation may impact patient safety and management, workflow and healthcare costs. These findings highlight the responsibility of education providers in medical radiation science to align curricula with current evidence rather than out‐of‐date guidelines. This evidences the need to seek consensus in the guidelines and ensure that we adapt both teaching and practice in accordance with contemporary knowledge. Conclusion: Persistent myths around contrast safety delay changes in practice. 2,3 Clinical decision‐making is further complicated by potentially incorrect or incomplete ‘allergy’ flags available in the radiology information system or any other electronic medical record. Without consensus, practice and language, the management of patients is at risk of being compromised. This review seeks to bridge this gap between current practice and best practice, promoting safer, more consistent and evidence‐based care globally. References 1. Wei Y, Jiang X, Hibberd M, Sampedro A, Rautenbach J. Estimating the rate of acute adverse reactions to non‐ionic low‐osmolar contrast media: a systematic review and meta‐analysis. Eur Radiol 2025:1–10. 2. Wulf NR, Schmitz J, Choi A, Kapusnik‐Uner J. Iodine allergy: Common misperceptions. Am J Health Syst Pharm 2021;78(9):781–93. 3. Sampson CS, Goddard KB, Bedy SC, Stilley JAW. The "myth" of iodine allergy to radiocontrast in emergency medicine. Am J Emerg Med 2019;37(7):1363–5. Quality audits and contrast reactions: A survival guide for radiology's wild side Tim Suhr 1 1 Lumus Imaging, Melbourne, Australia In a national imaging network, quality governance is less about ticking boxes and more about navigating complexity. At Lumus Imaging, we faced the challenge of improving clinical safety and audit engagement across diverse sites and modalities, while responding to real‐world incidents such as contrast reactions and extravasations. These events highlighted the need for better systems, clearer training and faster feedback loops. This presentation shares how we shifted from reactive auditing to proactive governance. Through the ongoing review of national audits and the introduction of targeted staff checklists, we embedded consistent practice and accountability into everyday workflows. Optimisation protocols were refined to balance diagnostic integrity with patient safety, while dose data and reference levels were continuously monitored to support compliance and improvement. We also navigated state‐based regulatory differences and addressed workforce capability gaps. Drawing on my transition from Imaging Manager to National Quality Governance Manager, this session offers practical insights into embedding governance into clinical practice, building audit literacy, and preparing for future national updates. It's a reflection on how listening to data, adapting systems, and discovering new approaches can turn governance into a meaningful driver of quality. Friday 27 March, 1:30 PM – 3:00 PM Discovering Paediatric Practice (MI) Can a low‐dose CT skeletal survey replace 33 X‐rays in the investigation of non‐accidental injury? Edel Doyle 1 , Richard Bassed 1,2 , Kam Lee 3 , Matthew Dimmock 1,4 1 Monash University, Melbourne, Australia, 2 Victorian Institute of Forensic Medicine, Melbourne, Australia, 3 ARPANSA, Yallambie, Australia, 4 Keele University, Keele, United Kingdom Introduction: A series of X‐rays is the current ‘gold standard’ of suspected non‐accidental injury. The aim of this research is to determine if a low‐dose CT (LDCT) skeletal survey scan can replace the radiographic skeletal series. Methods: Two literature reviews were conducted. A phantom study was undertaken to establish an estimated effective radiation dose and associated radiation risks. Ethical approval and a waiver of consent was obtained for a patient study to propose local diagnostic reference levels (LDRLs). A number of LDCT scans were acquired using a phantom to establish how low the dose could go while remaining diagnostic. Results: Both literature reviews identified a gap in current literature to support a change in clinical practice. 1,2 The typical doses for the X‐ray projections ranged from 3 to 86 mGy•cm 2 , and the effective doses ranged from 0.00004 to 0.07 mSv. 3 The median effective dose for a skeletal survey X‐ray series was 0.09 mSv. The additional radiation‐induced death is equivalent to the risk of dying from being struck by lightning. 4 The most common radiographs in the patient study were the chest, wrist, abdomen, elbow and foot. The proposed LDRLs ranged from 4 to 844 mGy•cm 2 . 5 The lowest dose achieved for a diagnostic CT scan was 0.09 mSv. Measurement of fracture detection across three studies suggests that it is difficult to identify more subtle fractures on LDCT. Conclusion: There is insufficient evidence to currently support a change in practice from a series of radiographs to a LDCT skeletal survey in the investigation of non‐accidental injury. References 1. Doyle E, Dimmock M, Lee K, Ng J, Bassed R. A systematised literature review: can low‐dose whole‐body computed tomography replace a radiographic skeletal survey when investigating paediatric non‐accidental injury? Forensic Imaging 2021;27:200481. https://doi.org/10.1016/j.fri.2021.200481 2. Doyle E, Bugeja L, Dimmock MR, Lee KL, Ng J, Bassed RB. Effectiveness of low dose computed tomography to detect fractures in paediatric suspected physical abuse: a systematic review. Int J Legal Med 2024. https://doi.org/10.1007/s00414‐024‐03214‐2 3. Doyle E, Dimmock MR, Lee KL, Thomas P, Bassed RB. Comparison of typical radiation doses and risks using an anthropomorphic ‘bone fracture’ phantom for commonly performed X‐ray projections in a 5‐year‐old. J Med Radiat Sci 2023. https://doi.org/10.1002/jmrs.717 4. Doyle E, Dimmock M, Lee K, Thomas P, Bassed R. Typical median effective radiation doses using an anthropomorphic bone fracture phantom for initial radiographic skeletal surveys in the investigation of suspected physical abuse. Pediatric Radiology 2022. https://doi.org/10.1007/s00247‐022‐05456‐x 5. Doyle E, Dimmock MR, Lee KL, Thomas P, Bassed RB. Proposed diagnostic reference levels for frequently performed paediatric radiographic examinations. J Med Radiat Sci 2025. https://doi.org/10.1002/jmrs.866 Hip hip hooray: It's paediatric hip day Andrew Grant 1 1 I‐MED, East Melbourne, Australia Ultrasound of the paediatric hip is the imaging modality of choice for early detection and assessment of developmental dysplasia of the hip. This presentation provides an overview of normal hip anatomy, scanning technique and interpretation using standard ultrasound methods. Key sonographic landmarks, measurement parameters and common pitfalls will be discussed to ensure accurate and reproducible evaluation. The presentation will also address the complementary role of the anteroposterior pelvis radiograph in older infants and children, outlining systematic assessment using Hilgenreiner's, Perkin's and Shenton's lines, as well as acetabular angle measurement. Emphasis will be placed on early diagnosis, appropriate imaging selection based on age, and the crucial role of imaging in guiding timely and effective management of developmental dysplasia of the hip to optimise long‐term outcomes. Red flags and real data: What 2 years of non‐accidental injury data tells us Carolyn Heyes 1 1 The Royal Children's Hospital Melbourne, Parkville, Australia Introduction: This retrospective study looks at 2 years of non‐accidental injury (NAI) skeletal surveys. The aim is to answer the following questions: What percentage of NAI skeletal surveys are positive? Is there a clinical indication that is more likely to result in a positive study? What percentage of referred patients are found to be victims of NAI? Method: The requests and reports of 2 years of studies were audited as well as the patient's clinical notes. The clinical indications on the request were compared to the patient's admission/emergency notes and their discharge notes. When a patient was discharged into care of other than their parent, the assumption is made that they are victims of NAI, regardless of the imaging outcome. Discussion: This presentation will discuss the results of the study and whether there are any clear indications that were commonly positive for NAI. This preliminary study may lead to further research into this area. Lights, camera, distraction: Practical tricks for paediatric radiographers Judith Reid 1 , Keahna Richards 1 1 The Royal Children's Hospital Melbourne, Parkville, Australia Performing diagnostic imaging on children presents unique challenges that require more than just clinical knowledge – it demands creativity, empathy and adaptability. This presentation will explore the personal insights and practical strategies that two experienced paediatric radiographers have developed through years of working with children in a clinical setting. Designed to support radiographers at any stage of their paediatric practice, this presentation will offer tips and tricks to improve patient cooperation, enhance image quality and reduce repeat imaging. Drawing on experience across multiple modalities, we’ll explore age‐appropriate communication, distraction techniques and positioning strategies. We hope to empower attendees with confidence and provide tools they can immediately implement in their own practice, ultimately improving the experience for both clinicians and children alike. Evaluating Australian radiographers’ knowledge, attitudes and reporting practices on child physical and sexual abuse Tehnan Shah 1 , Sergio Arancibia 1 , Nabita Singh 1 , Ayyaz Qadir 1 , Susan Baidawi 2 , Rubini Ball 2 1 Department of Medical Imaging and Radiation Science, Monash University, Melbourne, Australia, 2 Department of Social Work, Monash University, Melbourne, Australia Introduction: Australian laws have been evolving to incorporate increasing mandates for child abuse reporting across professions, including for radiographers in some states. 1 While radiographers may sometimes be positioned to encounter suspected child safety concerns, 2 laws vary between jurisdictions and are not addressed in professional capabilities required for accreditation. 3 This study examines radiographers’ knowledge, attitudes and practices towards reporting child abuse, an underexplored dimension of clinical responsibility. Methods: A quantitative survey based on a United Kingdom study 4 was created. Fifty participants across five states responded. Descriptive statistics evaluated associations between jurisdiction, qualification level and knowledge domains. Results: Jurisdictional confusion was prominent in responses, 52% of radiographers were unaware that laws vary between states. 60% believed there was insufficient time to observe safety concerns, despite reporting being an obligation in some Australian states. Only one‐third had completed postgraduate professional development in this area. 24% of participants claimed to encounter a case of suspected child safety concerns. Conclusion: Mandatory reporting laws may risk functioning more as a symbolic safeguard than as a practical mechanism, unless structural and educational barriers are addressed. Most radiographers expressed willingness to pursue professional development in this domain, but many deemed that workplace support and time were limitations. Targeted interventions, including curriculum reform to integrate safeguarding more comprehensively, clearer guidance on jurisdictional law and organisational cultures that actively support reporting, are essential if laws continue to evolve to include all Australian radiographers. References 1. Denham G. Mandatory reporting of child abuse requirements for medical imaging professionals throughout Australia. Radiographer 2008;55(3):9–12. 2. Antwi WK, Reeves P, Christine F, Aziato L. A qualitative description of how Ghanaian radiographers identify suspected child physical abuse. Radiography 2021;27(4):1073–7. 3. Medical Radiation Practice Board of Australia. Professional capabilities for medical radiation practice [Internet]. Available at https://www.medicalradiationpracticeboard.gov.au/Registration‐Standards/Professional‐Capabilities.aspx 4. Beck JJW, Wilson AW, Hardy M, Snaith B. Evaluating the role of the diagnostic radiographer in identifying child safeguarding concerns: a knowledge, attitude and practice survey approach. Radiography 2023;29(5):892–7. Friday 27 March, 1:30 PM – 3:00 PM Listening to Patient Voices From policy to practice: Embedding patient, public and practitioner partnership principles – The Society and College of Radiographers Charlotte Beardmore 1 1 The Society and College of Radiographers, London, United Kingdom Established in 2007 by the Society and College of Radiographers (SCoR), the Patient Advisory Group goal is to ensure the patient voice informs radiographic practice and policy in the United Kingdom. 1 Membership is open to individuals with lived experience of imaging and radiotherapy services, including carers and relatives. Members contribute to policy development, publication reviews, research and consultations, supporting SCoR's commitment to co‐production, quality improvement and patient‐centred care. Recently, lay representatives joined the UK Council Board and College Board of Trustees, embedding patient perspectives in strategic decision‐making. To support collaboration, SCoR created the Patient Public Practitioner Partnerships (4Ps) framework. 2 Developed through extensive engagement, it offers a values‐based approach to stakeholder involvement across four domains: service delivery, service development, education and research. Each section presents core principles illustrated by patient stories, participant quotes and public feedback, demonstrating the impact of partnership working. The 4Ps promotes inclusive, transparent and respectful engagement, placing the patient voice at the heart of quality improvement and professional development. Practical examples guide implementation across diverse settings. This presentation will outline the progress and significance of lay involvement in shaping radiographic policy and practice. 3 It will highlight how the Patient Advisory Group and the 4Ps framework can drive meaningful change and explore the evolving role of patient voice in strategic decision‐making, offering insights into how inclusive partnerships enhance service quality, professional development and person‐centred care. References 1. Society and College of Radiographers. Patient Advisory Group (PAG) [Internet]. Available at https://www.sor.org/about/get‐involved/advisory‐groups/patient‐advisory‐group‐%28pag%29 2. Society and College of Radiographers. Patient public and practitioner partnerships within imaging and radiotherapy: guiding principles [Internet]. Available at https://www.sor.org/learning‐advice/professional‐body‐guidance‐and‐publications/documents‐and‐publications/policy‐guidance‐document‐library/patient‐public‐and‐practitioner‐partnerships‐withi 3. Society and College of Radiographers. Education and career framework for the radiography workforce. Fourth edn [Internet]. Available at https://www.sor.org/learning‐advice/professional‐body‐guidance‐and‐publications/documents‐and‐publications/policy‐guidance‐document‐library/education‐and‐career‐framework‐for‐the‐radiogr‐%281%29 Dehumanised, objectified, discarded: Distress in MRI as a form of medical trauma Johnathan Hewis 1 1 Charles Sturt University, Port Macquarie, Australia Introduction: MRI is often considered a routine diagnostic procedure, yet for some individuals it can be an encounter of profound psychological harm shaped by an imbalance in power between patient and practitioner. 1‐3 This hermeneutic phenomenological study 4 explored the lived experience of distress in MRI revealing it can be experienced as a form of medical trauma. Central to this finding is the collective experience of dehumanising practices where participants felt deindividualised, objectified and ultimately discarded. Methods: Eight adults from regional and rural Australia were recruited who had experienced acute distress during MRI within the preceding 6 months. Semi‐structured interviews were conducted, supported by reflexive journaling, to provide deep insight into their lived experience in this ethics approved qualitative hermeneutic phenomenology study. 5 Member‐checking interviews with four participants enhanced trustworthiness. Results: Participants consistently described an MRI journey that felt mechanistic and transactional, marked by perfunctory communication and emotional detachment. They reported being reduced to a biomedical object and, if they deviated from practitioner expectations, treated as a burden. Accounts included feeling judged, dismissed or exposed to micro‐aggressions, compounding their distress. Post‐scan, many reported abrupt dismissal and abandonment, with lingering shame, self‐blame, avoidance of future MRI and erosion of trust in health care. These experiences align with definitions of medical trauma as encounters in care that overwhelm coping and inflict lasting psychological harm. Conclusions: Distress in MRI is not always transient procedural anxiety; it can constitute medical trauma. Restoring dignity requires relational presence and authentic engagement to humanise MRI practice and prevent avoidable harm. References 1. Hudson DM, Heales C, Vine SJ. Radiographer perspectives on current occurrence and management of claustrophobia in MRI. Radiography 2021. https://doi.org/10.1016/j.radi.2021.09.008 2. Homewood H, Hewis J. ‘Scanxiety’: content analysis of pre‐MRI patient experience. Radiography 2023;29:s68–s73. 3. Hewis J. Do MRI patients tweet? Thematic analysis of patient tweets about their MRI experience. J Med Imag Radiat Sci 2015;46:396–402. 4. van Manen M. Researching lived experience: human science for an action sensitive pedagogy. Second edn. New York: Routledge; 2016. 5. van Manen M. Phenomenology of practice: meaning‐giving methods in phenomenological research and writing. Walnut Creek, CA, Left Coast Press Inc; 2016. Trauma and survival: The journey beyond the image Sarah Mott 1 , Pauline Hext 1,2 1 Te Whatu Ora Waitematā – Health New Zealand, Auckland, New Zealand, 2 Allevia Radiology, Auckland, New Zealand Introduction: Trauma occurs without warning, which can leave lasting effects that can change lives forever. This case looks at the experience of a patient and his family following a life‐threatening pelvic injury sustained in a ride‐on lawnmower accident. It follows the patient's journey from critical injury to recovery and the adaptation beyond the hospital. Case Presentation: A 61‐year‐old male fell down a cliff on his ride‐on lawnmower, sustaining a complex and unstable pelvic fracture with life‐threatening internal blood loss. His survival occurred due to a rapid trauma response, imaging and surgical intervention. Management/Outcome: His recovery was filled with uncertainty, physical limitations and the challenge of adapting to a new ‘normal’. Throughout the recovery, his psychological resilience and determination were demonstrated through regaining independence and redefining his sense of strength and identity. Discussion: This presentation focusses on both the patient and family perspectives. It will include his radiological journey and the coping strategies, emotional impact and adaptations that occur after a life‐altering event. This case is being shared with the hope of deepening healthcare professionals’ understanding of the long‐term physical, emotional and social challenges of trauma. This will assist in better understanding a patient's journey when they come for imaging and encourage empathetic and patient‐centred care that extends well beyond the hospital walls. Patients listening to the voices of patients – The power of lived experience peer support David Bell 1 , Matthew Henry Scott 1 1 Gold Coast University Hospital, Gold Coast, Australia Polytrauma is a disease with a sudden onset that often results in a complex and chronic disease and a significantly altered life plan. Polytrauma clients are traditionally discharged from acute hospital care to rehabilitation, care institutions or home with the ongoing responsibility then falling on the primary care provider/GP. Many survivors and their carers struggle with this step down to an altered home life with impacts on mobility, functionality, relationships, finances and, ultimately, mental health. Noticing this perceived gap led us to seeking ways to improve and extend our support beyond discharge. We introduced a network for survivors of severe physical trauma to Australia. This program is multimodal with the most powerful aspect being the Lived Experience Peer Support Program. We have noted this program to be pivotal, instilling hope and motivation in our survivors, encouraging them in their recovery via the dynamic of lived experience. This support can be adapted to multiple health related services and scenarios. Friday 27 March, 1:30 PM – 3:00 PM Empowering Practitioners Powered by AI: Rethinking clinical education, training and documentation in medical radiation science Jamie Banks 1,2 1 Australian Society of Medical Imaging and Radiation Therapy, Australia, 2 GenesisCare, Lake Macquarie, Australia Education within the medical radiation sciences has traditionally relied on static procedural documents and manual updates that fail to match the pace of evolving clinical technologies. Internal protocols are developed by subject matter experts through literature review, conference inspiration and mentor/peer collaboration. Training resources are often developed secondary to the clinical procedure and can become fragmented, outdated, and disconnected from everyday workflow. This can limit the access, agility and recall for frontline staff in the day‐to‐day clinical environment and makes ‘teaching on the run’ a common occurrence. 1 There are two aspects to this project, both of which use the existing Microsoft 365 environment, the system ensures that procedural changes and associated training resources can be updated in close to real time, maintaining human touch points, governance and complete oversight: management workflow: document creation, implementation and training resources. Custom AI agents with defined prompts, operational guardrails and sandbox testing co‐designed with IT and governance to ensure safe, ethical use end‐user learning platform: a learner‐facing interface where clinicians engage in structured, AI‐facilitated dialogues modelling instructor‐led workshops and simulated clinical scenarios. These promote clinical reasoning, ethical reflection and technical skill development, bridging theory and practice. Expected outcomes include secure, internally owned learning ecosystems, reduction of external platform costs and measurable improvements in digital literacy, engagement and workflow efficiency. 2 By embedding learning within the tools clinicians already use, this initiative represents a paradigm shift to transform training from a static task into an adaptive, intelligent process that evolves with clinical innovation. 3 References 1. Teaching on the Run. Teaching on the Run workshop [unpublished]. Newcastle: TELL Centre, 2024. 2. Health Education England. Artificial intelligence: literature review and environmental scan [Internet]. 2021. Available at https://www.hee.nhs.uk/ 3. Tella V, Buscemi S, Andrews M. The new automation mindset: the leadership blueprint for the era of ai‐for‐everything. New York: McGraw Hill; 2023. Does preceptorship support being and becoming a diagnostic radiographer? Jane Harvey‐Lloyd 1 1 University of Leeds, Leeds, United Kingdom Introduction: The radiography profession is undergoing significant change in response to social, economic and political influences. This has resulted in increasing service demands and a requirement for graduates to possess a much wider range of skills. 1 The pressures now being placed on newly qualified health and social care practitioners has initiated research in both nursing and medicine that has focussed on the transition of student to practitioner 2,3 and the subsequent introduction of National Allied Health Professionals Preceptorship. The aim of this PhD was to explore the experience of transition from student to practitioner in diagnostic radiography and this presentation will discuss the findings in relation to current preceptorship provision within radiography. Method: An interpretive phenomenological approach was used consisting of three face‐to‐face interviews of each participant at 3 months, 6 months and 12 months post‐qualification. Thematic analysis was utilised and identified six themes. 4 Results: The six themes: 1) needing support; 2) settling in; 3) developing confidence; 4) becoming established; 5) feeling useful; and 6) looking forward, will be presented using direct quotations and images. These will be discussed alongside current preceptorships programs and inform a critical debate. Conclusions: role transition continues to be a stressful time the transition experience is heavily influenced by a range of factors much of the formal support given to the newly qualified radiographers is task orientated modifications and adjustments are needed to preceptorship programs to invidualise support with the inclusion of coaching to underpin and enhance the transition experience. References 1. Decker S. The lived experience of newly qualified radiographers (1950‐1985): an oral history of radiography. Radiography 2009;15(1):72–7. 2. Mooney M. Facing registration; the expectations and the unexpected. Nurse Education Today 2007;27:840–7. 3. Ross H, Clifford K. Research as a catalyst for change: the transition from student to registered nurse. Journal of Clinical Nursing 2002;11:545–53. 4. Gibson WJ, Brown AB. Working with qualitative data. London: Sage; 2009. Reflections from the Fellowship journey: Reimagining purpose, practice and the power of the profession Meegan Shepherd 1,2 , Nigel Anderson 2,3,4 1 Royal North Shore Hospital, St Leonards, Australia, 2 Monash University, Clayton, 3 Olivia Newton‐John Cancer Wellness & Research Centre, Heidelberg, Australia, 4 The Australian Society of Medical Imaging and Radiation Therapy (Board member), Melbourne, Australia What does it mean to grow alongside a profession that is itself transforming? For me, the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT) Fellowship has been both a mirror and a launchpad, reflecting how far we’ve come as radiation therapists and amplifying the voices that continue to shape where we’re going. Through ASMIRT, I’ve found not only a platform to grow but an audience to share with, colleagues who challenge, encourage and believe in the power of our collective purpose. My Fellowship journey has centred on advancing adaptive radiotherapy education and credentialling, locally and globally, pancreatic stereotactic body radiation therapy, exploring how advancing technology, patient‐centred care and value‐based health intersect in meaningful ways. Along this path, I’ve graduated my third master's degree, served on ASMIRT's Radiation Therapy and Artificial Intelligence reference groups and chaired the collaborative working group of ASMIRT, The Royal Australian and New Zealand College of Radiologists and the Australasian College of Physical Scientists and Engineers in Medicine developing the Guidelines for Safe Practice of Online Adaptive Radiotherapy, experiences that underscored the strength of collaboration and shared leadership. But this journey has never been mine alone. It has been inspired by my colleagues near and far, previous ASMIRT Fellows, sustained by my Fellowship mentor's guidance and made possible by the patients, staff and family who reminded me why the hours in PowerPoint, research and professional development truly matter. The ASMIRT Fellowship has transformed how I see myself and my profession – as part of something larger, a community serving our patients. This reflection invites pause, reconnection with purpose and how together we can continue to lead the evolution of care now and into the future. A structured new graduate radiographer program to empower early‐career practitioners Jessica Watson 1 , Adam Steward 1 1 Western Health, Melbourne, Australia A recent gap analysis within our large multi‐campus teaching health service revealed that graduate radiographers, particularly those transitioning from external healthcare placements, required extended supernumerary time and support to gain confidence and competence in adaptive technique, as well as mobile, fluoroscopy and theatre imaging. This demonstrated a clear need to strengthen the bridge between university training and clinical expectations within the public health setting. Funding and specific transition to practice criteria from a training and development fund provided an opportunity to re‐imagine early‐career support through a structured new graduate program. Using an established first‐ to fourth‐year expectations framework, aligned to the Medical Radiation Practice Board of Australia professional capabilities, development of a scaffolded approach to guide growth across the graduate year was established. Central to this initiative is an Allied Health Clinical Supervision Framework, 1 integrated via a learning management system, and a dedicated mentorship model led by developing educators within the department. These educators provide ongoing guidance, structured feedback and monthly mentor‐mentee meetings supported by the training and development funding. A complementary six‐part new graduate lecture series addresses key aspects of professional transition including wellbeing, workplace culture, financial literacy and clinical adaptability. Through this multi‐layered approach, we have fostered a culture of learning, guidance and support that empowers new graduates to thrive. The program enhances clinical competence, confidence and professional identity – ensuring the next generation of radiographers are not only technically skilled but also supported, reflective and ready to contribute meaningfully to the profession. Reference 1. Department of Health and Human Services, State Government of Victoria. 2019. Victorian Allied Health Clinical Supervision Framework. Available at https://www2.health.vic.gov.au/health‐workforce/allied‐health‐workforce ASMIRT eLearning: A new era in medical radiation science Steve Lacey 1 1 The Australian Society of Medical Imaging and Radiation Therapy, Melbourne, Australia The development of the ASMIRT eLearning platform represents a major advancement in the Australian Society of Medical Imaging and Radiation Therapy's commitment to professional education and lifelong learning. Designed to meet the evolving needs of medical radiation practitioners, the platform integrates flexible, accessible and engaging online learning opportunities within a single digital ecosystem. The project focussed on creating a user‐friendly interface that supports interactive modules, multimedia resources and self‐paced courses aligned with professional standards and capability requirements. Collaborating with subject matter experts, medical radiation practitioners and educators, ASMIRT ensured the content was evidence‐based, clinically relevant and pedagogically sound. Key features include performance tracking and integrated assessment tools to measure competency and continuous development. This presentation will provide an overview of the journey in developing the platform, as well as a demonstration of its key features and interactive capabilities. Through ongoing updates and responsive design, ASMIRT eLearning will continue to evolve alongside advances in technology and healthcare practice. Friday 27 March, 3:30 PM – 5:30 PM Navigating Remote Challenges Strengthening cancer care in the Asia‐Pacific region through data harmonisation and capacity building Vikneswary Batumalai 1,2 , Angela Liao 1 , Mei Ling Yap 1,2 1 The George Institute for Global Health, UNSW Sydney, Sydney, Australia, 2 School of Clinical Medicine, UNSW Sydney, Sydney, Australia Cancer remains a leading cause of death across Asia and the Pacific, with low‐ and middle‐income countries accounting for more than 70% of global cancer diagnoses and nearly 60% of cancer deaths. The demand for radiotherapy is projected to rise steeply over the next two decades, highlighting the urgent need for harmonised, high‐quality data systems to guide equitable and effective cancer care. As part of the International Atomic Energy Agency's (IAEA) Rays of Hope initiative, this regional project was launched through a partnership between the IAEA, the Australian Department of Foreign Affairs and Trade, and the Australian Nuclear Science and Technology Organisation. The initiative aims to strengthen the collection, sharing and use of oncology data across 19 participating Asia‐Pacific countries. In 2025, over 50 radiation oncology professionals convened in Sydney for a 4‐day workshop to improve capacity in data governance, service planning and research. Delegates shared national experiences implementing oncology information systems and reached consensus on developing an Asia‐Pacific Minimum Dataset for Radiation Oncology, designed to capture diagnosis, staging, treatment intent and demographic information in a consistent, standardised manner. By fostering collaboration, regional capacity building and data harmonisation, this initiative represents a critical step toward a unified, evidence‐based framework for cancer care supporting stronger policy development, improved service quality and more equitable outcomes across the Asia‐Pacific region. Radiation therapists in the wilderness: Clinical trial implementation in rural settings Rachael Beldham‐Collins 1,2 , Sandra Taylor 3 , Denise Andree‐Evarts 2 , Marissa Morey 2 , Susan Carroll 2,4 , Joseph Chan 4 , Catherine Osborne 1,2 1 Central West Cancer Care Centre, Orange, Australia, 2 Western Cancer Care Centre, Dubbo, Australia, 3 Dubbo Health Service, Dubbo, Australia, 4 Northern Sydney Cancer Care Centre, St Leonards, Australia Introduction: Clinical trials are critical to advancing radiation therapy, yet participation from rural centres remains limited due to logistical and resource related barriers. 1 Radiation therapists (RTs) in rural settings often assume additional responsibilities to support trial activities, potentially impacting workload and job satisfaction. This study explored RTs’ perceptions and experiences following implementation of the first clinical trial at a rural radiation therapy centre. Methods: An anonymous survey was emailed to all RTs at the rural centre that initiated its first clinical trial in mid‐2025. The survey included multiple‐choice, Likert scale and open‐ended questions assessing experiences with trial implementation, workload impact, training adequacy and support needs. Data were analysed using descriptive statistics and thematic analysis. Results: Response rate was 92% (11/12). All RTs received trial related training, with 63.6% (7/11) participating in trial activities including patient consent, screening, treatment planning, data collection/entry, auditing and trial coordination. Perceptions were positive: 71.4% (5/7) strongly agreed/agreed clinical trial work was valued departmentally, though 28.6% (2/7) reported poorly defined role responsibilities. Staff shortages were the primary barrier, while clear protocols/workflow processes were key enablers. Five themes were identified regarding motivators and supports for sustained involvement: 1) advancing equity of care; 2) professional growth and development; 3) adequate workforce capacity; 4) dedicated resources and infrastructure; and 5) recognition and organisational support. Conclusion: RTs demonstrated strong commitment to clinical trial implementation, motivated by equity of care and professional growth. Successful rural trial participation is achievable with investment in workforce capacity and research infrastructure, offering a model for expanding access in rural centres. Reference 1. Graffini J, Johnston K, Farrington A, McPhail SM, Larkins S. The Australian clinical trial landscape: perceptions of rural, regional and remote health service capacity and capability. Health Res Policy Sys 2024;22(1):171. Adapting cancer and vaccine technology to control Tasmanian devil facial tumour disease in the wilderness Andrew Flies 1 1 Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia The two independent, clonal transmissible cancers known as Tasmanian devil ( Sarcophilus harrisii ) facial tumour 1 (DFT1) and DFT2 are simultaneously cancer, infectious agents and allografts. DFT1 and DFT2 both arose independently from Schwann cells and have undergone sustained natural transmission in the wild since at least 1996 and 2014, respectively. The transmissible cancers evade host immunity despite accumulated mutations in tumour cells and MHC‐I mismatches between tumour cells and hosts. Our objective is to develop an oral cancer vaccine that can be distributed in edible baits to control DFT1 and DFT2 in the Tasmanian wilderness. We probed RNA‐seq data sets to quantify expression of protein‐coding mutations that can be used as vaccine neoantigens. Target neoantigen peptides were then fused into a polypeptide neoantigen open reading frame and encoded into the genome of an adenoviral vector. In parallel to in vitro vaccine testing, we have developed a novel wildlife health intelligence system for distributing baits and monitoring devil behaviour in the field. Navigating change in isolation: Maintaining radiotherapy operating during a CT upgrade in a remote setting Brett Mcdonald 1 1 Northern Territory Radiation Oncology, Darwin, Australia Upgrading critical equipment in a remote radiation therapy department presents unique operational challenges, particularly when continuity of patient care must be maintained. As the only radiation therapy service in the Northern Territory, our department is preparing for a planned CT scanner replacement while ensuring there are no delays to commencing radiotherapy treatment. To navigate this period, we have coordinated with an external PET‐CT facility, requiring frequent communication, negotiation and flexibility across institutional boundaries. This scenario highlights the importance of proactive planning, clear communication channels and collaborative problem‐solving. Anticipated strategies include adjusting patient schedules, coordinating staff availability and planning for potential technical or logistical disruptions. Challenges such as differing institutional workflows and limited resources demand adaptability and creative solutions. By reflecting on anticipated processes and lessons, we aim to identify key principles applicable to similar remote or isolated healthcare services: listening to stakeholders, anticipating disruptions, and cultivating strong interdepartmental relationships. This planned experience reinforces that operational excellence in health care is not solely about technical expertise but also about navigating complex human and logistical systems. Sharing these approaches and reflections will offer insights for other services managing equipment upgrades in constrained or remote environments, demonstrating that collaboration, adaptability and clear communication are fundamental to sustaining safe and effective patient care. Rural medical radiation practice in Australia: A collaborative autoethnography of constraints, adaptations and professional identity Shayne Chau 1 , Kelly Spuur 1 , Jenny Han 2 1 Charles Sturt University, Wagga Wagga, Australia, 2 Bendigo Health, Bendigo, Australia Introduction: Rural health is commonly framed through a deficit lens that emphasises scarcity and poorer outcomes, obscuring the adaptive capacities of rural services. The lived experiences of medical radiation practitioners in these contexts are underreported. Methods: A collaborative autoethnography was conducted by three medical radiation practitioners practising in rural Australia. 1 Personal narratives and recorded reflective dialogues were generated and transcribed. Data were subjected to reflexive thematic analysis using Braun and Clarke's framework and situated within the rural health literature to locate individual accounts within system‐level dynamics. Results: Four analytic themes were identified. First, limited specialist access and variable referral vetting were known to lead to duplicate examinations and higher cumulative radiation exposure among rural patients. Second, workforce fragility, characterised by vacancies, turnover and multi‐modality demands, constrained access to continuing professional development, contributed to skill degradation and reduced job satisfaction. Third, practitioners’ own health care was impeded by compromised privacy, difficulty obtaining leave and delayed specialist access, leading to burnout and moral distress. Fourth, despite structural pressures, community integration, relational continuity and locally tailored problem‐solving engendered professional meaning and a sense of agency. Conclusions: Rural medical radiation practitioners sustain broad, patient‐centred practice under conditions of scarcity while enacting context‐specific innovations. Mitigating radiation‐safety risks and workforce vulnerability requires system‐level supports, including standardised referral and imaging protocols, protected and resourced continuing professional development with tele‐mentoring, privacy‐preserving access to care for staff, and strengthened rural generalist pathways. Reframing rural radiography from deficit to capability, while addressing structural gaps, is central to equitable and safe service delivery. Reference 1. Chau MT, Spuur KM, Han J. Rural resilience: a collaborative autoethnographic study of medical radiation practitioners. Radiography 2025;31(6):103178. Friday 27 March, 3:30 PM – 5:30 PM AI in Practice (MI) Artificial intelligence fracture detection: Assessing readiness for clinical practice in Australia Erin Crotty 1 1 Queensland University of Technology, Brisbane, Australia Introduction: Diagnostic errors and missed fractures in the emergency department have been a topic of research for more than four decades. 1 The evolving face of artificial intelligence (AI) fracture detection tools may propose a solution, however, there is limited evidence available analysing the accuracy of the tools and assessing their overall readiness for adoption into clinical practice. Methods: A comprehensive literature search was conducted across PubMed, Embase, CINAHL, Scopus and Cochrane. Reference lists of relevant articles were also reviewed for additional studies. Sources published in English between 2020 and 2025 were included if they were primary studies, evaluated multiple anatomical regions, utilised a commercially available AI fracture detection tool, and reported on the tool's sensitivity and specificity. Results: 19 studies met the inclusion criteria. One study assessed three tools, resulting in 21 sets of results. Within these studies, seven AI fracture detection tools were evaluated, however, only three currently have Therapeutic Goods Administration approval in Australia. Fourteen studies included data on adults, while 12 included data on children. Overall, sensitivity was higher than specificity in 17 of 21 evaluations, indicating most commonly, the AI tools are better at correctly identifying patients with fractures compared to correctly ruling out patients with no fractures. There are, however, variations in results between different studies and tools, and there is no current data from an Australian context. Conclusion: While further research is required, this study demonstrated AI fracture detection tools may, in the future, be a beneficial addition to radiographer preliminary image evaluation and radiology reporting. Reference 1. Berman L, de Lacey G, Twomey E, et al. Reducing errors in the accident department: a simple method using radiographers. Br Med J (Clin Res Ed) 1985;290:421–2. Discovering our professional identity: Diagnostic radiography in the age of AI and automation Johnathan Hewis 1 1 Charles Sturt University, Port Macquarie, Australia To be a nurse is to care, 1 midwifery is a calling, yet radiography's professional identity is more elusive, traditionally framed by the machine and the technical. 2 Yet it is the (often invisible) space between patient and machine that the radiographer's distinctive professional identity resides. 3 Radiography stands at an existential crossroads in the era of artificial intelligence, where increasing automation of image acquisition and interpretation continues to reshape our practice. 4 The temptation may be to retreat into purely technical roles. What defines us from radiology is not the image, rather the human encounter. Radiologists interpret images, often at a distance; radiographers are present with patients in moments of vulnerability, explaining, reassuring, supporting and preserving trust. We manage their fear, maintain their dignity, and compassionately give human meaning to a technological process that can be mechanistic. 5 Our proximity places care, rather than technology, at the centre of our professional practice. 6 This presentation explores why we must hold fast to what makes us irreplaceable; the ability to bridge technology and humanity, to acknowledge and care for the person as well as the image. Care is not a nice extra or add‐on to technical competence. It is the ontological and ethical foundation of radiography practice. Radiography may not survive as a technical function alone. Our future depends on strengthening person‐centred care, in being the human mediator between patient and machine, image and meaning. If we fail to do so, we may discover too late that we have handed our identity to the machine. References 1. Watson J. What is nursing science? Ontological‐epistemological disciplinary questions. Adv Nurs Sci 2025;00(0):1–3. https://doi.org/10.1097/ANS.0000000000000587 2. Yielder J, Davis M. Where radiographers fear to tread: resistance and apathy in radiography practice. Radiography 2009;15(4):345–50. 3. Niemi A, Passivaara L. Meaning contents of radiographers’ professional identify as illustrated in a professional journal – a discourse analytical approach. Radiography 2007;13:258–64. 4. Hewis J. A salutogenic approach: changing the paradigm. J Med Imaging Radiat Sci 2023;54(2):S17–21. https://doi.org/10.1016/j.jmir.2023.02.004 5. Hancock A, Bleiker J. But what does it mean to us? Radiographic patients and carer perceptions of compassion. Radiography 2023;29(Suppl 1):S74–80. 6. Hyde E, Hardy M. Patient centred care in diagnostic radiography (Part 2): a qualitative study of the perceptions of service users and service deliverers. Radiography 2020;26(4):e232–e8. Radiography in the age of AI: Building trust, shaping diplomacy, advancing care Nareuchaya Karoonuthaisiri 1 1 PRP Imaging, Sydney, Australia Artificial intelligence is no longer a distant concept in medical imaging; it is already reshaping how we work, learn and collaborate. Yet while the algorithms advance rapidly, professional understanding of AI often lags behind. The risk is that decisions about implementation are made without the voices of those closest to patient care. The opportunity is that by cultivating AI literacy, radiographers can move beyond being end‐users. This presentation offers a concise ‘AI literacy crash course’ for medical radiation practitioners accompanied with a commentary on AI literacy as both a professional competency and a form of influence. This includes demystifying common terms (machine learning, deep learning, neural networks), understanding the basics of model training and bias, recognising the role of datasets and appreciating the ethical challenges of explainability and accountability. This draws on insights from courses/summits such as the RMIT AI Product Managers Short Course, the AI for Medical Imaging and Radiotherapy Professionals program at City St George's, University of London, and the AI Innovation Asia Summit in Singapore. Three themes frame the commentary: first, AI literacy as a safeguard for patients, ensuring safety and ethics are not overshadowed by novelty. Second, AI literacy as professional currency, strengthening radiographers’ ability to collaborate across disciplines and borders. Third, AI literacy as momentum, turning education into workshops, presentations and shared knowledge that ripple beyond individual careers. AI literacy is not about learning machines; it is about refining our human capacity to lead with trust, purpose and vision in an era of transformation. Enhancing emergency preparedness in radiology using AI‐generated simulations Charlie Murrell 1,2 1 RHCNZ Medical Imaging Group, New Zealand, 2 Pacific Radiology, Waikato, New Zealand Emergency preparedness in radiology is challenged by the rarity and unpredictability of acute contrast reactions, which can leave staff underprepared and lacking confidence. Following a cluster of serious contrast‐related incidents, our team implemented AI‐generated simulation scenarios to improve clinical readiness and team coordination. These simulations, developed using Microsoft Copilot, replicate lifelike emergencies tailored to modality‐specific environments such as CT, MRI and X‐ray. The scenarios include randomised variables, real‐time role assignments and interactive decision points, followed by structured debriefs and feedback loops. Preliminary outcomes show improved staff engagement, faster response times and an enhanced understanding of emergency protocols. Literature supports the efficacy of AI‐driven training, with reported increases in protocol adherence and confidence. Future directions include expanding simulations of pediatric and MRI‐specific emergencies and fostering cross‐disciplinary collaboration. This approach offers a scalable, adaptive and cost‐effective model for embedding emergency preparedness into routine radiology practice. Deep learning‐based classification of rejected radiographs Emerald Nguyen 1 , Daniel Carrion 2 , Stanley Norris 2 , Luke Monsour 2 , Mohamed Badawy 1,2 1 Monash University, Melbourne, Australia, 2 Monash Imaging, Melbourne, Australia Introduction: Repeat imaging due to positioning errors, clipped anatomy, artefacts, patient movement and technical errors contributes to unnecessary radiation exposure and delays in patient care. 1,2 Reject analysis is a quality assurance process that evaluates the rates and reasons for rejected radiographs. 3 Methods: This research assesses the performance of AI model YOLOv11 in identifying the reason for rejection. The study included a dataset of 17,611 radiographs, which were randomly divided into subsets for training (70%), validation (20%) and testing (10%). Convolutional neural network YOLOv11 was selected for defect classification due to its advanced feature detection and optimised architecture. Results: Model performance demonstrated a strong positive correlation with training sample size (Pearson r = 0.815, p < 0.001), with 66.4% of the variance in F1 scores attributable to the sample count. Classes with more than 1000 training samples achieved mean F1 scores above 0.80, whereas those with fewer than 100 samples demonstrated substantially poorer performance (mean F1 < 0.30). Results support the need for sufficient training data to develop reliable AI models, particularly with underrepresented classes. Conclusion: Clinical decision‐making remains an integral part of the radiographer's role, and AI can serve as an adjunct to streamline the process of reject analysis, guiding continual professional development of qualified radiographers and students. Notably, this is the first study to train YOLOv11 for defect classification across multiple anatomical regions. References 1. Dasegowda G, Kalra M, Abi‐Ghanem A, et al. Suboptimal chest radiography and artificial intelligence: the problem and the solution. Diagnostics 2023;13(3):412. https://doi.org/10.3390/diagnostics13030412 2. Stephenson‐Smith B, Neep MJ, Rowntree P. Digital radiography reject analysis of examinations with multiple rejects: an Australian emergency imaging department clinical audit. J Med Radiat Sci 2021;68(3):245–52. https://doi.org/10.1002/jmrs.468 3. Haddad L, Saleme H, Haworth N, Tack D. Reject analysis in digital radiography and computed tomography: a Belgian imaging department case study. J Belg Soc Radiol 2023;107(1):100. https://doi.org/10.5334/jbsr.3259 Artificial intelligence supported clinical scenario learning in radiography education: Development of the ‘Bill’ prototype Shayne Chau 1 , Greg Higgins 1 , Elio Arruzza 2 , Clare Singh 1 1 Charles Sturt University, Wagga Wagga, Australia, 2 The University of South Australia, Adelaide, Australia Introduction: Artificial intelligence (AI) offers transformative potential in medical radiation science education by providing scalable, interactive and adaptive learning environments. This technical note describes the design and feasibility testing of ‘Bill’, an AI‐driven clinical scenario coach created to simulate realistic clinical challenges for undergraduate radiography students. Methods: Bill was developed through a collaboration between academic staff and clinical practitioners using OpenAI's GPT‐4o platform. The tool was designed to align with the Medical Radiation Practice Board of Australia's Professional Capabilities for Medical Radiation Practitioners and evidence‐based educational principles. Clinical scenarios ranged from performing mobile X‐rays on critically ill patients to managing near‐miss incidents in fluoroscopy. Each scenario incorporated multiple‐choice and open‐ended questions, real‐time feedback, and reflective prompts to promote critical thinking, clinical reasoning and self‐reflection. Results: The prototype demonstrated the feasibility of using AI to replicate complex clinical situations in radiography education. Bill adaptively guided learners through case‐based interactions, providing structured feedback and formative assessment tailored to scenario complexity. The system effectively modelled professional reasoning, supported the development of soft skills such as communication and empathy, and offered a low‐risk environment for practice. Conclusions: Bill represents an innovative approach to integrating AI into radiography education, bridging the gap between theoretical learning and clinical application. While still in an experimental phase, the prototype demonstrates the potential for AI‐driven scenario‐based learning to enhance student engagement, autonomy and preparedness for clinical practice. Future research should evaluate student outcomes and long‐term educational impact. Friday 27 March, 3:30 PM – 5:30 PM Discovering MRI Innovation (RT) Adapting to unity in the Australia New Zealand region Jenna Dean 1 , Hilary Byrne 2 , Charles Tan 2 , Jesse Fayers 2 , Tommy Liang 2 , Victoria Olivant 3 , Sandie Fisher 1 , Elizabeth Denyer 4 , Jessica De Favari 4 , Sweet Ping Ng 1 , Drew Smith 1 1 Olivia Newton‐John Cancer & Wellness Centre, Heidelberg, Australia, 2 GenesisCare, Sydney and Perth, Australia, 3 St George's Cancer Care Centre, Christchurch, New Zealand, 4 Townsville Cancer Centre, Townsville, Australia Introduction: The Elekta Unity MR‐Linac has been in clinical use in the Australia New Zealand (ANZ) region since 2019. With this advanced technology came enhanced image quality, the ability to monitor soft tissue in real time to assess/manage intrafraction motion, as well as online adaptive planning to account for anatomical and/or positional changes. Objective: The aim of this research was to review the patterns of Unity utilisation in ANZ over the initial years of clinical use. This audit was undertaken to gain an understanding of how this may have changed as users have become confident with the technology and clinical applications have expanded. Methods: An ethically approved retrospective audit was conducted at all clinical Unity sites in our region. Data was collected for treatments delivered between December 2019 and December 2024. The total number of courses and delivered fractions were collated to demonstrate the collective utilisation over time. Age, gender, tumour site, dose, fractionation and adaption method were also collected. Results: Since December 2019, 1575 patients and 15,116 fractions have been delivered across ANZ Unity departments. The highest utilisation has been seen for prostate, pelvic/abdominal nodes, liver and pancreas. Additional anatomical sites have been introduced, with a transition from conventional to hypofractionated schedules where clinically suitable. Conclusions: Departments in ANZ are adapting to the use of Unity with increasing use cases, primarily soft tissue targets, in combination with hypofractionated treatment schedules. It will be interesting to observe changes in utilisation with future developments in Unity, including comprehensive motion management. Adapting the vision for gynaecological cancer external beam radiotherapy and brachytherapy workflows and protocols Trinity Murfett 1 , Julie Burbery 1 , Catriona Hargrave 1,4 , Katie McMahon 1,3 , Jemma Blyth 2 , Kate Stewart 2 1 Queensland University of Technology, Brisbane, Australia, 2 Royal Brisbane and Women's Hospital, Brisbane, Australia, 3 Herston Imaging and Research Facility, Brisbane, Australia, 4 Princess Alexandra Hospital, Brisbane, Australia Introduction: As MRI is invaluable in tumour and organ localisation in gynaecological cancer radiotherapy, 1 this study commissioned brachytherapy (BT) applicators (Fletcher‐Suit‐Delclos Varian) in a 3 Tesla MRI scanner then reviewed and adapted radiotherapy imaging protocols. Methods: This ethics approved study commissioned MRI sequences for three BT applicators and collected organ volumes (bladder, rectum, cervix, uterus) and scan times from two healthy volunteers’ MRIs. Image quality ratings were performed on different image sequences. Volume variation metrics (including Hausdorff distance, Dice similarity coefficient) were used to compare the intrafraction variability from neutral bladder (NB) versus active filling (AF) bladder protocols. Results: Safe MRI parameters were developed from BT applicator commissioning. The 2D transverse plane demonstrated the best image quality (median = 3, upper quartile = 4.25). The NB protocol had the largest bladder volumes and smallest rate of bladder filling across all image sequences (NB average = 1.60 cm 3 /minute, AF average = 3.16 cm 3 /minute). Consequently, the average Dice coefficients were 0.9 (NB) versus 0.64 (AF). This minimised changes in adjacent organ volumes, particularly the cervix and uterus. The rectum volumes displayed the greatest variations, likely due to moving gas and matter. Conclusion: This study confirmed the safe use and benefits of MRI for gynaecological radiotherapy planning scans, supporting their use as the new standard of care to improve treatment outcomes. The NB protocol may be more optimal in ensuring the reproducibility of organs. However, due to inter‐participant variability, the most appropriate protocol could be adapted for personalised care at simulation. Reference 1. Dimopoulos JCA, Petrow P, Tanderup K, et al. Recommendations from Gynaecological (GYN) GEC‐ESTRO Working Group (IV): basic principles and parameters for MR imaging within the frame of image based adaptive cervix cancer brachytherapy. Radiother Oncol 2012;103(1):113–22. https://doi.org/10.1016/j.radonc.2011.12.024 MR‐guided adaptive radiotherapy treatment: A multi‐disciplinary approach to daily online adaptive treatment Daniel Pham 1 1 Stanford Medicine, Palo Alto, California, United States MR‐guided adaptive radiotherapy (MRgART) enables re‐optimisation of a treatment plan based on changes in patient anatomy on the day of treatment. In September 2022, our institution installed and went clinical with a 0.35T MR‐guided adaptive radiotherapy machine. With a focus on stereotactic ablative body radiotherapy treatment for prostate, liver, pancreatic and kidney cancers, our institution developed both image‐guided radiation therapy‐only and adaptive workflows for these clinical sites. A multi‐disciplinary team consisting of two radiation therapists, a dosimetrist, a medical physicist and an attending physician were mandatory for each adaptive treatment session. Over the past 2 years, our institution has treated more than 300 patients with this system. With over 1000 adaptive sessions treated; our current workflow has a median treatment duration of 49 minutes (range: 19 min – 1 hr 58). MRgART treatment is a complex process that requires communication among members of the multi‐disciplinary team. Attendees to this presentation will: learn about clinical sites that are suitable or not for MRgART treatment learn and see examples of ‘plan‐robustness’ when planning for on‐table adaptation see the advantages of a parallel workflow design for adaptive treatment appreciate the dosimetric advantages/disadvantages of an MR‐linac system. Gradient of change: Redefining MRI for radiotherapy workflows Kate Skehan 1 , Matthew Richardson 1 1 Calvary Mater Newcastle, Newcastle, Australia Magnetic resonance imaging is becoming integral to radiotherapy (RT) planning, but its adoption requires rethinking of both technique and culture. Diagnostic MRI typically prioritises image contrast and appointment efficiency, whereas RT demands geometric accuracy, reproducible positioning and clear delineation of targets and organs at risk. Achieving this requires protocol customisation – high bandwidths, isotropic resolution, distortion correction and true axial orientation – together with equipment and workflows tailored for RT simulation. Collaboration between MRI radiographers, radiation therapists, radiation oncologists, radiologists and physicists is vital to this optimisation, but MRI access remains uneven. Departments vary widely in their pathways: dedicated MRI simulators, shared in‐house diagnostic scanners or reliance on scans imported from external providers. This lack of standardisation creates barriers to consistent MRI practice for RT purposes and risks embedding inequities in care. Safety is another central challenge. The integration of MRI units into radiation oncology departments introduces ‘atypical’ environments where conventional radiology frameworks may not apply. Embedding a safety culture – supported by clear policies, defined responsibilities and tailored training for all staff working in the MR environment is essential if MRI is to be used effectively and safely in RT. Ultimately, MRI's role in RT is not just about sharper images. It is about safe integration into new clinical environments, bridging disciplinary divides and ensuring equitable access for patients. Progress will depend as much on building cultures of collaboration and safety as on technical advances. MRI‐guided adaptive stereotactic radiation therapy for kidney and adrenal lesions: Strategies and technical considerations Maria Thomason 1 , Brayden Geary 1 , Ronan Joyce 1 , Daryl Lim Joon 1 , Ee Siang Choong 1 1 Austin Health, Melbourne, Australia MRI‐guided adaptive radiotherapy offers improved visualisation of targets and normal tissue along with real‐time monitoring of tumour position and motion during treatment delivery. Stereotactic body radiotherapy provides a non‐invasive alternative for treating localised renal cell carcinoma, in patients who are not candidates for surgery. 1,2 Conventional X‐ray‐based imaging for abdominal lesions can be limited due to potential poor soft tissue contrast and challenges assessing motion, 3 to confirm both appropriate target margins and organ at risk avoidance. MRI‐guided adaptive radiotherapy for renal cell carcinoma was clinically implemented at our centre in 2023. In work previously presented by our group, in 90% of fractions, real‐time adaptive planning improved dose to at least one organ at risk and ensures clinician confidence in treating these lesions to high doses. This presentation will outline our experience, from the perspective of a radiation therapist, to treating kidney and adrenal lesions with MRI‐guided adaptive radiotherapy, including MR image acquisition, deformable contour propagation, daily adaptive planning, system limitations and future directions. References 1. Siva S, Ali M, Correa RJM, et al. 5‐year outcomes after stereotactic ablative body radiotherapy for primary renal cell carcinoma: an individual patient data meta‐analysis from IROCK (the International Radiosurgery Consortium of the Kidney). Lancet Oncol 2022;23(12). 2. Siva S, Bressel M, Sidhom M, et al. Stereotactic ablative body radiotherapy for primary kidney cancer (TROG 15.03 FASTRACK II): a non‐randomised phase 2 trial. Lancet Oncol 2024;25(3). 3. Pham D, Kron T, Foroudi F, Schneider M, Siva S. A review of kidney motion under free, deep and forced‐shallow breathing conditions: Implications for stereotactic ablative body radiotherapy treatment. Technol Cancer Res Treat 2014;13(4). Friday 27 March, 3:30 PM – 5:30 PM Evolving Clinical Collaboration (MI) Fostering a safety culture: Enhancing team learning through a clinical incident review program Kate Dahlenburg 1 , Nicole Turley 1 1 Logan Hospital, Meadowbrook, Australia Health care is a complex and dynamic environment. Within its provision, there is an unfortunate reality that risk can never be fully eliminated among the people, systems and processes that exist within it. Acceptance of this risk and recognising clinical incident reviews as an opportunity for learning and improvement are key to fostering a culture of safety. Those responsible for the investigation and management of clinical incidences (typically those in senior leadership positions) are frequently exposed to the review learnings, however, translation of that learning to frontline clinical teams in a supportive and safe format is imperative for the delivery of safe and high‐quality imaging services. A 6‐month trial of a clinical incident review program commenced within a public hospital medical imaging department (MID) in September 2025. An ethics waiver was granted by the Metro South Human Research Ethics Committee. The trial consisted of a series of workshops facilitated by the MID quality and safety team, where groups of four to five team members were invited to review real (de‐identified) clinical incidents that had occurred within the MID. Workshop groups worked together to review a pre‐prepared case report, identify contributing factors to the incident occurring, and drew on the diverse perspectives of each team member to brainstorm a set of recommendations for improvement and future risk mitigation. This presentation will provide attendees with an overview of the clinical incident review program, discuss initial evaluations from the trial period, and provide key resources that can be adapted for use within other medical imaging facilities. Remote X‐ray operators in Australia: A scoping review of self‐perceived radiographic competence and educational needs Rebecca Kilday 1 , Minh Chau 2 1 Royal Darwin Hospital, Darwin, Australia, 2 Charles Sturt University, Wagga Wagga, Australia Objectives: Remote X‐ray operators (RXOs) are non‐radiographer healthcare workers who perform basic radiographic examinations in rural and remote areas due to workforce shortages. RXOs frequently report low confidence in their radiographic skills and limited access to continuing professional education. This scoping review maps the available evidence on RXOs’ self‐perceived competence and educational needs. Methods: A scoping review was conducted following PRISMA‐ScR guidelines. Medline, CINAHL and Embase were searched for studies published between January 2004 and August 2024. Eligible studies focussed on RXO training, competence or educational needs. Data were extracted on study aims, methods and reported outcomes. A descriptive synthesis was used to identify key themes across the included literature. Results: Nine studies were included. Recurring themes included RXOs’ limited confidence in key radiographic tasks, reliance on radiographers for supervision and training, and significant barriers to accessing continuing professional education due to geographic isolation. Training models varied considerably across jurisdictions, with inconsistent supervision and credentialing. Studies reported improved outcomes when RXOs had access to structured, practical training and radiographer‐led support. Conclusion: RXOs consistently identify gaps in their radiographic knowledge and express strong interest in further education. Flexible and standardised continuing professional education models, delivered through remote supervision, digital tools and targeted mentorship, may help address variability in training and support across regions. Expanding access to remote learning platforms and radiographer mentorship could strengthen RXO preparedness and service delivery. Nationally consistent licensing and training requirements may improve care quality and patient safety in underserved settings. Prostatic artery embolisation for the treatment of benign prostatic hyperplasia: A local experience Don Nocum 1,2 1 The University of Sydney, Sydney, Australia, 2 North Shore Private Hospital, Sydney, Australia Benign prostatic hyperplasia is a condition affecting men over 50 years of age, characterised by the enlargement of the prostate gland, leading to lower urinary tract symptoms. 1 Management traditionally includes pharmacotherapy or minimally invasive surgical therapies such as transurethral resection of the prostate. Prostatic artery embolisation (PAE) has emerged as a minimally invasive, image‐guided alternative with favourable safety and efficacy profiles. 2 PAE involves the use of image‐guidance with angiography and the embolisation of bilateral prostatic arteries that supply the enlarged prostate. The prostatic arteries are selectively catheterised and particulate embolics are used to block off the blood supply and promote a reduction in size of the prostate gland, thus alleviating patient symptoms and discomfort. This presentation explores our local experience of introducing PAE to treat patients with benign prostatic hyperplasia within a private hospital interventional radiology setting. Procedures were performed using both an older and upgraded angiography unit equipped with vessel navigation software and cone beam CT, enabling precise navigation of complex pelvic arterial anatomy. Interventional radiologists applied specialist embolisation techniques, supported by interventional radiographers who optimised image quality and radiation dose, and managed advanced software applications. 3 Our workflow demonstrates that successful delivery of PAE requires a collaborative approach tailored to individual vascular anatomy, with efficiency and radiation safety central to procedural outcomes. The experience at this site can inform current interventional treatment options for patients with symptomatic benign prostatic hyperplasia and showcase emerging interventional radiology procedures that deliver minimally invasive, patient‐centred care through advances in technology and angiographic imaging techniques. References 1. Mouli S, Salem R, McClure TD. Prostate artery embolization for benign prostatic hyperplasia. The Journal of Urology [Internet]. 2024. Available at https://www.auajournals.org/doi/10.1097/JU.0000000000003976 2. Sapoval MR, Bhatia S, Déan C, et al. Two‐year outcomes of prostatic artery embolization for symptomatic benign prostatic hyperplasia: an international, multicenter, prospective study. Cardiovasc Intervent Radiol 2024;47(11):1515–24. 3. Schott P, Bilhim T, Fischman A, et al. Evaluation of vessel tracking software for prostatic artery embolization. Cardiovasc Intervent Radiol 2024;47(10):1407–13. Evidence‐based interdepartmental collaboration: Developing an acute cervical spine injury transfer policy Christopher Parsons 1 1 Northeast Health Wangaratta, Wangaratta, Australia Introduction: Acute cervical spine (C‐spine) injuries require timely imaging while ensuring patient safety. Variability in transfer practices, combined with workforce pressures, posed risks of secondary injury and inconsistent application of spinal precautions. Prior to policy implementation, radiographers and nursing staff faced uncertainty regarding their scope of practice in C‐spine transfers, often resulting in unnecessary patient handling, over‐scanning and delayed imaging. These practices increased the risk of pressure injuries, aspiration and radiation exposure. This initiative aimed to standardise transfer practices, balancing patient safety with efficient use of available staff resources. Method: An interdepartmental working group reviewed current evidence, including contemporary decision‐making rules, 1 and aligned processes with evidenced‐based practice to ensure imaging was clinically justified. 2,3 The policy clarified roles: radiographers focus on transfer co‐ordination, prompt medical imaging and preliminary image evaluation, while spinal precautions‐trained nurses, doctors or paramedics manage immobilisation and monitoring. A structured transfer pathway, presented as a contemporary decision‐making rule, was implemented, encompassing request protocoling, transfer supervision, scanning and post‐scan return. Evaluation: Retrospective pre‐ and post‐implementation audits demonstrated improved compliance with spinal precautions, reduction in unnecessary CT requests and clearer delineation of professional roles. Conclusion: The project demonstrates that evidence‐based interdepartmental collaboration can reconcile workforce demands with patient safety, safeguard against over‐scanning and enhance professional accountability. By integrating clinical decision rules and structured workflows, the policy fosters safer, more efficient care for acute C‐spine patients while supporting professional development in line with contemporary standards. References 1. Phillips N, Rasmussen K, McGuire S, et al. Projected paediatric cervical spine imaging rates with application of NEXUS, Canadian C‐Spine and PECARN clinical decision rules in a prospective Australian cohort. EMJ 2021;38(5):330–7. 2. Vaillancourt C, Charette M, Sinclair J, et al. Implementation of the Modified Canadian C‐Spine Rule by paramedics. Ann Emerg Med 2023;81(2):187–96. 3. Hong R, Qassin S, Zhao C, et al. CT Utilisation in emergency department assessment of patients with suspected polytrauma: impact of a dedicated trauma surgical team. J Med Imaging Radiat Oncol 2025;69(3):317–27. Embedding imaging within emergency: A satellite model for enhanced patient‐centred care Nick Ardley 1 1 Monash Health, Clayton, Australia In order to improve efficiency and meet rising demand for emergency‐referred imaging examinations, a new satellite imaging department has been established within the emergency department (ED) of a major metropolitan hospital. This initiative was designed to improve access and responsiveness for emergency patients requiring X‐ray, CT and ultrasound services. The project involved relocating emergency imaging from the central medical imaging department to a dedicated ED‐based facility, exclusively serving emergency presentations. This separation from inpatient and outpatient workflows allows imaging staff the ability to focus exclusively on emergency cases. This has led to improved responsiveness and reduced delays. Existing ordering and procedural workflows remain unchanged with the only change being the physical location of service delivery. The dedicated imaging space within the ED allows timely access to diagnostics with minimal interference from broader hospital demand, ensuring critically unwell patients can be imaged promptly without leaving the ED environment. Preliminary data comparing turnaround times before and after implementation show a notable improvement in general X‐ray services, with up to a 16% reduction in time to scan. CT turnaround times also improved, particularly during business hours, though gains were less consistent overnight. The results highlight the value of infrastructure changes in improving efficiency and patient care. Locating imaging within the ED has streamlined the imaging service, enabling faster access for clinical teams and improving the overall patient experience in emergency care. CT left atrium imaging in acute stroke presentations Wilbur Wong 1 , Roisin Lynam 1 1 Princess Alexandra Hospital, Brisbane, Australia Introduction: In Australia, a stroke event occurs approximately every 11 minutes. 1 Acute ischaemic stroke may result from thrombotic, hypoperfusion or embolic causes, and identifying the underlying source is vital for secondary prevention. Embolic strokes comprise around 30% of ischaemic strokes, 2 often originating from the left atrial appendage (LAA). Cardioembolic strokes carry a high recurrence risk, and while echocardiography and rhythm monitoring are standard investigations, echocardiography is operator‐dependent and typically delayed until after acute management. ECG‐gated CT demonstrates high sensitivity (96%) and specificity (92%) for detecting LAA thrombus. 3 Methods: The stroke team introduced a trial for LAA imaging in stroke presentations to identify embolic sources. Patients presenting with suspected acute ischaemic stroke undergo standard CT imaging, with additional ECG‐gated left atrium imaging performed in selected cases. Inclusion criteria include acute stroke presentation during business hours. Exclusion criteria include anticoagulation therapy, atrial fibrillation, severe left ventricular dysfunction and other contraindications. Results: 18 patients have been recruited to date. Four showed cardiac abnormalities, and three demonstrated LAA thrombus. Notably, a 46‐year‐old male with middle cerebral artery occlusion had an LAA filling defect identified on imaging. Due to bleeding risk from alcoholism, thrombolysis was withheld, and successful interventional clot retrieval was performed. As the embolic source was confirmed through left atrial imaging, no further cardiac investigations were required. Conclusion: ECG‐gated left atrium imaging is a promising adjunct in acute ischaemic stroke assessment, allowing early identification of embolic sources and guiding management. Further research is warranted to define its role in routine stroke protocols. References 1. Stroke Foundation. New report highlights number of strokes hits all‐time high [Internet]. 2024. Available at https://strokefoundation.org.au/media‐centre/media‐releases/2024/09/new‐report‐highlights‐number‐of‐strokes‐hits‐all‐time‐high 2. Ghozy S, Liu M, Kobeissi H, et al. Cardiac CT vs echocardiography for intracardiac thrombus detection in ischemic stroke: a systematic review and meta‐analysis of 43 studies. Neurology 2024;103(7):e209771. https://doi.org/10.1212/WNL.0000000000209771 3. Romero J, Husain SA, Kelesidis I, et al. Detection of left atrial appendage thrombus by cardiac computed tomography in patients with atrial fibrillation. Circulation: Cardiovascular Imaging 2013;6(2):185–94. https://doi.org/10.1161/CIRCIMAGING.112.000153 Friday 27 March, 3:30 PM – 5:30 PM Evolving Stereotactic Practice (RT) The unique challenges of establishing a Gamma Knife service: Live radiation source for cranial stereotactic radiotherapy Claire Newlove 1 1 Icon Cancer Centre, Brisbane, Australia Objective: To describe the implementation of the Leksell Gamma Knife system within Australia's private healthcare sector, focussing on technological advancements, collaboration and the logistical complexities of establishing a dedicated intracranial radiosurgery service. Methods: To enhance cranial radiosurgery capability, two Leksell Gamma Knife units were acquired purpose‐built systems utilising 192 cobalt‐60 sources to deliver highly focused, frameless or frame‐based intracranial treatments with sub‐millimetre precision. Commissioning the first unit at Herston required overcoming substantial infrastructure, regulatory and workflow challenges, including the delivery and management of live radioactive sources and coordination with radiation safety authorities. Collaboration with established Gamma Knife centres, alongside staff visits and overseas vendor training, was integral in developing local expertise. Results: Transitioning from linac‐based to Gamma Knife practice demanded strategic planning, strong peer support and tailored credentialing processes. Comprehensive vendor and external training informed workflow design and clinical governance updates. The appointment of a dedicated radiation safety officer and the implementation of stringent safety protocols ensured the safe operation of the cobalt‐based system within a fully shielded facility. Conclusions: Commissioning of the Gamma Knife system successfully addressed the unique logistical and safety challenges associated with a live radiation source and complex facility infrastructure. Collaboration with experienced centres accelerated workflow development, while international training provided the specialised expertise required to establish a safe and effective cranial radiosurgery service. MR‐guided stereotactic radiotherapy for pancreatic tumours: A promising approach for local control with low toxicity Vivienne Ng 1 , Yew Sin 1 , Lyndsey Edwards 1 , Farshad Kasraei 2 , Hilary Byrne 2,3 , Eugene Leong 1 , Kasri Rahim 1 , Jeremy de Leon 2 , Hendrick Tan 1 1 GenesisCare, Western Australia, 2 GenesisCare, New South Wales, Australia, 3 The University of Sydney, Sydney, Australia Introduction: MR‐guided radiotherapy (MRgRT) permits adaptive radiotherapy with superior soft tissue delineation delivering ablative doses in locally advanced pancreatic cancer (LAPC). This study evaluated the efficacy and tolerability of MRgRT in primary LAPC. Methods: Data was collected from a dual‐institution registry for patients receiving SBRT (45–50 Gy in 5 fractions) to the pancreas. Included patients had unresectable LAPC receiving upfront chemotherapy (Cohort 1), metastatic pancreatic cancer receiving upfront chemotherapy (Cohort 2), and secondary pancreatic cancer (Cohort 3). The endpoints studied were acute and late >G3 toxicities (CTCAE v5.0), local control, distant progression‐free survival and overall survival. Results: 54 patients were enrolled. Table 1 presents the patient demographics in each cohort. Local control rates for Cohort 1 at 6‐ and 12‐months were 86.7% (n = 13/15) and 60% (n = 6/10), respectively. Distant progression‐free survival at 6‐ and 12‐months was 66.7% (n = 12/18) and 26.7% (n = 4/15), respectively. Overall survival at 6‐ and 12‐months was 88% (n = 22) and 84% (n = 21), respectively. Cohort 2 showed overall survival at 6‐ and‐12 months of 78.9% (n = 15/19) and 47.7% (n = 9/19), respectively. Overall survival for Cohort 3 at 6‐ and 12‐months was 100% and 90%, respectively. Recorded toxicities showed seven acute G3 toxicities and eight late >G3 toxicities, with the most common being biliary obstruction (n = 7) and partial small bowel obstruction (n = 2). Conclusion: This first Australian study on MRgRT for LAPC highlights the promising potential for local control and relatively low >G3 toxicity rates. Implementing multi‐criterial optimisation for multi‐metastatic SRS planning: Efficiency through standardisation Hardeep Rajput 1 1 Cancer Care Associates, Sydney, Australia Introduction: Consistent stereotactic radiosurgery (SRS) planning across multiple centres requires both clinical and technical standardisation. Following development of a network‐wide guideline covering prescription, margins, image‐guided radiation therapy (IGRT) and physics quality assurance, multi‐criterial optimisation (MCO) was introduced to improve efficiency and reproducibility in planning for multiple brain metastases. Methods: Five retrospective multi‐met cases (single‐ and dual‐prescription) were replanned using two approaches: non‐MCO – manual optimisation where the user adjusts cost‐function choice and isoconstraints as required, and MCO‐enabled – standardised template design with scalable values across prescriptions; MCO automatically drives cost‐function priorities and isoconstraints. Metrics included conformity index, gradient index, monitor units and planning time. All plans used a 0.2 cm grid and 0.5 % statistical uncertainty. Results: All plans met clinical dose constraints for targets and organs at risk. MCO plans achieved conformity index ≥0.8 in six of eight prescription levels compared with four of eight for non‐MCO, demonstrating improved conformity and reduced variability. Mean monitor units was 7–10 % lower for MCO plans, with an average planning time of ~30 minutes versus ~60 minutes for non‐MCO. Brain‐PTV D0.1 cc remained within tolerance across all cases. Conclusion: Embedding MCO within a clinically standardised SRS framework improved plan quality, efficiency and inter‐user consistency. Establishing uniform prescriptions, quality assurance processes and IGRT protocols created the foundation for reliable automation – demonstrating that clinical standardisation and technical innovation must progress together. Rectifying access: Patient‐reported outcomes comparing rectal displacement devices in prostate SBRT Joanne Higgins 1 , Matthew Richardson 1 , Lee Wilton 1 , Jarad Martin 1 1 Calvary Mater Newcastle, Newcastle, Australia Introduction: The PROMETHEUS trial was a single‐arm, multi‐centre, phase 2 study evaluating the safety and efficacy of ultra‐hypofractioned SBRT in patients with localised intermediate or high‐risk prostate cancer (ACTRN12615000223538). 5‐year results have been published. 1 The use of a rectal displacement device (RDD) was mandated: either a surgically implanted hydrogel or a temporarily inserted rectal separator. Long term comparative data between RDDs is limited. This study investigated any differences in patient reported bowel toxicity between RDD cohorts up to 5 years post‐treatment. Methods: 151 patients were accrued; 95 received hydrogel, 56 a rectal separator. Patients completed an EPIC‐26 questionnaire at baseline, end of treatment, and 12‐, 36‐ and 60‐months. 2 Statistical comparison of bowel domain scores was performed. Results: Raw EPIC‐26 bowel scores were slightly favourable for the rectal separator at end of treatment and at 12 months (Fig. 1), however two‐tailed t‐tests and two‐way ANOVA revealed no statistically significant differences at any time point over 5 years, with both cohorts returning to baseline. Conclusion: Both RDDs resulted in similar patient‐reported bowel toxicity. For departments unable to provide hydrogel due to limited specialist access, or cost barriers, a temporary rectal separator presents a low‐cost option with no expected detriment in HRQoL outcomes. Beyond toxicity outcomes, this study highlights how diverse technologies can support equitable access to advanced radiotherapy techniques and inform clinical decision‐making for future practitioners across varied practice settings. Fig 1. Mean EPIC‐26 bowel domain scores for hydrogel and rectal separator patients to 5 years post‐prostate SBRT. References 1. Wegener E, Sidhom M, Pryor D, et al. Prostate virtual high‐dose‐rate brachytherapy boost: 5‐year results from the PROMETHEUS Prospective Multicentre Trial. Eur Urol Oncol 2024;7(5):1042–50. https://doi.org/10.1016/j.euo.2024.01.008 2. Wei JT, Dunn RL, Litwin MS, Sandler HM, Sanda MG. Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health‐related quality of life in men with prostate cancer. Urology 2000;56(6):899–905. https://doi.org/10.1016/s0090‐4295(00)00858‐x Advancements in stereotactic body radiation therapy for prostate cancer Lily Stein 1 1 University of Newcastle, Newcastle, Australia Introduction: Prostate cancer remains one of the most prevalent malignancies affecting men worldwide and is effectively managed with radiation therapy. Stereotactic body radiation therapy (SBRT) delivers high‐dose radiation in fewer fractions using advanced technology for precise tumour targeting. This literature review examines SBRT's efficacy, toxicity profile and clinical applications in localised prostate cancer, with particular focus on biochemical control and quality of life outcomes. Methods: A comprehensive literature search was conducted using PubMed and ScienceDirect databases. Eligible studies published between 2015 and 2025 included prospective clinical trials or meta‐analyses with >50 patients, reporting biochemical recurrence‐free survival (bRFS), toxicity using CTCAE/RTOG scales or patient‐reported outcomes. Results: Five studies demonstrated SBRT's efficacy, achieving 95.3% 5‐year bRFS 2 and 92.3% 10‐year bRFS in low‐ to intermediate‐risk patients treated with 35–40 Gy delivered in 4–5 fractions. 3 High‐risk cases achieved 83% 5‐year disease control with SBRT boost regimens. 1 Late grade ≥3 genitourinary and gastrointestinal toxicities remained low (1–3%), while acute urinary symptoms affected 27–35% of patients but typically resolved within weeks. 1‐3 MR‐guided radiotherapy and adaptive planning techniques further reduced toxicity risks. 1‐3 Conclusion: SBRT offers comparable efficacy to conventional fractionated radiation therapy while significantly reducing treatment duration, substantially improving patient convenience. Ongoing research investigating patient‐specific factors, including age and comorbidities, alongside technological innovations such as AI‐driven treatment planning and real‐time adaptive strategies, could further optimise clinical outcomes. Enhanced global access to SBRT technology and accumulation of robust long‐term follow‐up data remain essential to solidify SBRT's role across diverse prostate cancer populations. References 1. De Cooman B, Debacker T, Adams T, et al. Stereotactic body radiotherapy (SBRT) as a treatment for localized prostate cancer: a retrospective analysis. Radiat Oncol 2025;20:25. https://doi.org/10.1186/s13014‐025‐02598‐8 . 2. Jackson WC, Silva J, Hartman HE, et al. Stereotactic body radiation therapy for localized prostate cancer: a systematic review and meta‐analysis of over 6,000 patients treated on prospective studies. Int J Radiat Oncol Biol Phys 2019;104(4):778–89. https://doi.org/10.1016/j.ijrobp.2019.03.051 3. Kennedy TAC, Sethukavalan P, Catton C, et al. Stereotactic body radiation therapy (SBRT) for localized prostate cancer: 10‐year outcomes from three prospective trials. Int J Radiat Oncol Biol Phys 2025;121(2):325–30. https://doi.org/10.1016/j.ijrobp.2024.09.009 The volumetric and dosimetric impacts of respiratory motion management in lung SBRT: A systematic review Bonan Zhang 1,2 , Maeve Kearney 1 , Laure Marignol 1 1 Trinity College Dublin, Dublin, Ireland, 2 National University Cancer Institute, Singapore Introduction: Several respiratory motion management strategies (active and non‐active) have been developed to quantity and account for motion to increase local control and reduce toxicities in lung stereotactic body radiotherapy (SBRT). 1 However, the extent of volumetric and dosimetric benefit of each strategy and selection criteria remain unclear. 2 This systematic review assesses the extent of target volume reduction and lung dose reduction in lung cancer patients treated with SBRT, comparing between strategies. Methods: A search was conducted across multiple databases, covering from 2019 to 2024. The PRISMA (Fig.1) were followed to identify relevant studies. Data on target volume size and dung dose metrics were extracted. Results: 14 studies involving 273 patients with early‐stage lung cancer or lung metastases were identified. Active respiratory motion management approaches consistently reduced planning target volume (PTV) sizes and spared lung tissue more effectively than non‐active methods. Mean PTVs were smaller with active strategies: non‐active 36.35 cm 3 , breath hold 26.26 cm 3 , phase‐gating 30.18 cm 3 , and tracking 12.48 cm 3 . Corresponding lung dose metrics were: non‐active 8.3%, breath hold 3.4%, phase‐gating 8.3%, and tracking 3.8%. Tracking demonstrated the greatest PTV reduction (34.2%) and lung sparing (39.2%), followed closely by DIBH in lung protection (39.5%). Tumours in the lower lobes and with >10 mm motion showed greater benefit from active strategies. Conclusion: While tracking was most effective, DIBH offered similar lung dose reduction but may be unsuitable for patients with compromised lung function. The findings support a tailored approach to respiratory motion management selection based on tumour location and motion extent. References 1. Bucknell NW, Belderbos J, Palma DA, et al. Avoiding toxicity with lung radiation therapy: an IASLC perspective. J Thorac Oncol 2022;17(8):961–73. https://doi.org/10.1016/j.jtho.2022.05.003 2. Hugo GD, Campbell J, Zhang T, Yan D. Cumulative lung dose for several motion management strategies as a function of pretreatment patient parameters. Int J Radiat Oncol Biol Phys 2009;74(2):593–601. https://doi.org/10.1016/j.ijrobp.2008.12.069 Saturday 28 March, 9:30 AM – 11:00 AM Optimising General Radiography (MI) Exploring the imaging quality standard from the College of Radiographers and Royal College of Radiologists Charlotte Beardmore 1 1 Society and College of Radiographers, London, United Kingdom The Quality Standard for Imaging (QSI) is jointly owned by the College of Radiographers and the Royal College of Radiologists in the United Kingdom. The QSI, together with the Quality Mark scheme supports the Colleges strategic commitment to embedding continuous quality improvement across all UK imaging services. QSI enables providers to assess their operational performance, identify areas for enhancement, and implement changes that aim to improve patient experience and clinical outcomes. 1,2 Developed through a rigorous, multi‐disciplinary process, QSI encompasses the collective expertise of lay representatives, radiographers, radiologists, medical physicists and sonographers. Its evolution has been shaped by extensive consultation with professional peers, regulatory bodies and UK government agencies, ensuring its relevance and applicability across diverse service contexts. 3 As a benchmark of excellence, QSI defines best practice standards to support and underpin safe, effective and patient‐centred imaging care. Formal assessment against the standard remains a defining feature of high‐quality imaging services; services that meet the standard are awarded the Quality Mark. Recognising the dynamic nature of clinical practice, QSI is subject to independent review every 4 years to maintain alignment with emerging evidence, technologies and service models. 2 This review is in progress and launch of the updated standard will be at the UK Oncology Congress in June 2026. This presentation will showcase the importance of collaboration in delivery of the QSI and provide an update about the QSI itself. References 1. Society and College of Radiographers, Royal College of Radiologists. Quality standard for imaging (QSI) [Internet]. Available at https://www.sor.org/quality‐standard‐for‐imaging‐qsi 2. The Royal College of Radiologists. 2024. Quality standard for imaging version 1.2 [Internet]. Available at https://www.rcr.ac.uk/media/ertlfuth/250508_qsi_standards‐2024‐v6‐1.pdf 3. The Royal College of Radiologists. Quality standard for imaging networks (QSIN) [Internet]. Available at https://www.rcr.ac.uk/our‐services/management‐service‐delivery/quality‐standard‐for‐imaging‐qsi/quality‐standard‐for‐imaging‐networks‐qsin/ Navigating image quality: Reducing subjectivity through threshold‐based auditing Sophie McKenzie 1 , Tate Brazil 1 , Adam Steward 1,2 1 Western Health, Melbourne, Australia, 2 RMIT University, Melbourne, Australia Navigating the complexities of radiographic imaging quality requires more than numbers alone. Reject analysis, while useful, presents a shortfall for assessment of quality performance, given that it is a largely quantitative measure that cannot capture quality of output, nor appropriateness of rejection. To address this, an image quality analysis tool was developed and applied as a weekly radiographic image quality audit, embedding a structured and qualitative approach that also reduces subjectivity in image evaluation. The audit is synchronised to complement reject analysis by monitoring trends in quality longitudinally and ensures that improvements in reject rates are not achieved at the expense of diagnostic standards. Preliminary findings show that the auditing process has enabled the development of threshold values, providing a reliable benchmark for evaluating future images for quality. Considered alongside reject analysis, this combined approach offers a more comprehensive view of departmental performance: one that balances quantitative data of reject analysis with less subjective evaluation of image quality, informs adaptive practice, and generates new insights into radiographic care. The presentation will focus on how threshold values are created, how results are monitored against them over time, and how these findings are integrated with reject analysis to strengthen overall radiographic performance of a department. Future directions include formal research to assess the level of subjectivity through cross‐auditing multiple projections by multiple participants. Findings which may have the potential to shape auditing practice, safeguard image quality and support evidence‐based improvements across departments. Discover the hidden clinical questions Jemima Howell 1 , Emma Banthorpe 1 1 Princess Alexandra Hospital, Brisbane, Australia Introduction: Imaging requests typically lack sufficient clinical information, with vague indications such as ‘chest pain’ and ‘constipation’ often given as the sole reason for imaging. 1 To adapt to this challenge, radiographers are required to listen to the subtext of request forms and discover implied clinical questions, however this is not always easy. When requests contain incomplete clinical questions, and radiographers lack nuanced understanding, it creates scope for unnecessary repeats and misguided confidence in the diagnostic value of radiographs produced. 2‐4 Radiologist reports offer a deeper knowledge of presenting clinical indications, and this knowledge could be utilised by radiographers to adapt examinations, in keeping with Medical Radiation Practice Board of Australia Professional Capabilities for Medical Radiation Practitioners – Capability 1.4c. 5 Objective: The aim of this improvement project was to create an educational resource for radiographers to deepen their knowledge of implied clinical questions for chest, abdomen and combined foot/ankle X‐ray requests. Method: A retrospective audit of chest, abdomen and foot/ankle X‐ray requests and correlated radiology reports (100 for each) was conducted. Extra information provided in reports by radiologists was recorded to uncover additional clinical questions. A review of reference literature was also undertaken to uncover the ‘hidden’ meaning behind missing and vague clinical questions in requests. Results: The outcome of this project is an educational resource for radiographers and students. The resource includes the five most common clinical indications for each body region, expanded to include implied clinical questions. It is anticipated this resource will allow radiographers to fully understand referrals and make more confident critiquing decisions. References 1. Mettler FA. Essentials of radiology. 4th edn. Elsevier; 2018. 2. Zhang J, Makanjee C, Hayre C, Lewis S. Australian graduate radiographers’ perspectives and experiences of work readiness. J Med Radiat Sci 2023;70(3):254–61. 3. Mackay S, Anderson A, Hogg P. Preparedness for clinical practice – perceptions of graduates and their work supervisors. Radiography 2008;14(3):226–32. 4. Rao R. Audit of radiology request forms ‐ “Are they adequately filled?” JMSR 2014;2(1):41–4. 5. Medical Radiation Practice Board of Australia. 2020. Professional capabilities for medical radiation practitioners. Available at https://www.medicalradiationpracticeboard.gov.au/documents/default.aspx?record=WD19%2f29238&dbid=AP&chksum=qSaH9FIsI%2ble99APBZNqIQ%3d%3 Adapting elbow radiography to improve detection of the posterior fat pad sign Blake Keir 1 1 Princess Alexandra Hospital, Brisbane, Australia Objective: The posterior fat pad sign (PFPS) on a lateral elbow radiograph is a positive predictor of intra‐articular injury. 1 It is important for diagnosis; however, acceptable imaging quality is poorly defined. This study quantifies the effect of centre point (CP) on PFPS visualisation in simulated radiographs. Methods: A custom X‐ray simulator was developed, and an elbow CT dataset with a PFPS was processed to generate 53,361 synthetic cone beam lateral elbow radiographs across 441 CPs and 121 different simulated patient positions. These images were then processed by custom automatic grading software that recognised whether a PFPS was present and then measured its thickness and contrast‐to‐noise ratio (CNR). Additionally, an audit of 100 lateral elbow radiographs was performed to characterise the CP typically used by radiographers in practice. Results: Figure 1 illustrates a heat map of the 441 CPs overlaid onto a simulated X‐ray and their respective PFPS thicknesses, if visible (CNR >1.5). In the audit (n = 100), the median CP used by radiographers in practice was calculated to be 16.7 mm (IQR 15.8–26.3 mm) superior and 10 mm (IQR 2.0–20.3 mm) anterior to the centre of the elbow joint. The mean PFPS thickness for the median radiographer CP, elbow joint CP, and the optimal simulated CP was 5.31 mm, 5.41 mm and 5.78 mm, respectively. Conclusion: In a novel approach, this experiment has demonstrated that the CP on a lateral radiograph does affect posterior fat pad sign visualisation. Reference 1. Afacan MA, Kilic KK, Temiz A, Tayfur İ, Doganay F. Diagnostic accuracy of fat pad sign, X‐ray, and computed tomography in elbow trauma: implications for treatment choices – a retrospective study. Peer J 2025;13:e18922. https://doi.org/10.7717/peerj.18922 The subtle errors that matter: Assessing tilt vs rotation in AP chest X‐ray acceptability Jenny Tran 1 , Adam Steward 1 1 Western Health, Melbourne, Australia Introduction: Accurate chest positioning during radiography requires alignment in both the vertical (tube tilt) and horizontal (patient rotation) planes. 1 While vertical tilt often receives greater attention, horizontal rotation is frequently overlooked despite its potential to distort mediastinal, clavicular and cardiac landmarks. 2 This study aimed to compare the impact of vertical tilt and horizontal rotation on anteroposterior (AP) chest X‐ray acceptability, as assessed by experienced radiographers. Method: A controlled phantom study was conducted. A baseline AP chest projection was acquired with the X‐ray beam perpendicular to the sternum and the clavicular heads aligned at T4. Vertical tilt was adjusted in 2° increments from −30° to +30°, while horizontal rotation was varied in 2° increments from −20° (right) to +20° (left). Randomised images were independently reviewed by 30 experienced radiographers who rated diagnostic acceptability using a structured evaluation template. Results: When rotated towards the left, images within 0–4° were consistently acceptable (97–100%), but acceptability declined to 70% at 6–8° and 17% at 10°, with no acceptable images beyond 12–20°. Right rotation was more tolerable, with 93–100% acceptance up to 6°, gradually declining to 20% at 20°. For vertical tilt, images with 0–14° downward angulation remained highly acceptable (97–100%), declining to 27% at 30°. Upward tilt was acceptable up to 6° (90–100%), but rapidly deteriorated beyond 8°, reaching 0% by 28–30°. Conclusion: Horizontal rotation had a greater effect on perceived AP chest X‐ray quality than vertical tilt. Radiographers should prioritise horizontal alignment to reduce image rejection and repeat exposures. References 1. Hobbs D. Chest radiography for radiologic technologists. Radiol Technol 2007;78(6):494–519. 2. Dasegowda G, Kalra MK, Abi‐Ghanem AS, et al. Suboptimal chest radiography and artificial intelligence: the problem and the solution. Diagnostics 2023;13(3):412. https://doi.org/10.3390/diagnostics13030412 Quantitative assessment of image quality for varying grid and scatter correction strategies Amir Zobeiri 1 , Adam Steward 1,2 1 Western Health, Melbourne, Australia, 2 RMIT University, Melbourne, Australia Introduction: Scatter radiation is a primary cause of image contrast degradation in digital radiography. Anti‐scatter grids improve quality but require substantial exposure increases, creating a critical trade‐off with patient dose. 1 Software‐based corrections have emerged as promising, dose‐neutral alternatives. 2 This study quantified the impact of various grid ratios and an ‘auto grid’ algorithm on objective low‐contrast detectability. Methods: A CDRAD 2.0 phantom with scattering media was imaged. Projections included abdomen, posterior‐anterior (PA) chest and mobile anterior‐posterior (AP) chest. Exposures were performed using no grid, multiple grids of different ratio and the auto‐grid algorithm. Image quality was evaluated using the inverse Image Quality Figure (IQFᵢₙᵥ) derived from automated CDRAD analyser software. Statistical analysis used ANOVA and Tukey's tests. Results: The use of anti‐scatter grids significantly improved low‐contrast detectability. Higher grid ratios yielded superior image quality (lowest IQFᵢₙᵥ). The 12:1 grid provided the best performance in abdomen projections. For PA chest, the 10:1 and 13:1 grids performed comparably. The auto grid algorithm produced image quality significantly better than no grid but was inferior to an 8:1 physical grid, particularly at higher kVp confirming it as a dose‐efficient alternative not requiring exposure compensation. 3 Conclusion: Physical grids require specific, substantial exposure increases to realise their full image quality benefit. The auto grid algorithm provides a viable, dose‐neutral strategy for mobile radiography, though it does not match physical grid performance. These findings provide a framework to optimise protocols, justifying exposure increases with improved diagnostic image quality. References 1. Bontrager KL, Lampignano J. Bontrager's handbook of radiographic positioning and techniques. 8 edn. Saint Louis: Elsevier; 2013. 2. Sayed M, Knapp KM, Fulford J, Heales C, Alqahtani SJ. The impact of X‐ray scatter correction software on abdomen radiography in terms of image quality and radiation dose. Radiography 2024;30(4):1125–35. 3. Renger B, Brieskorn C, Toth V, et al. Evaluation of dose reduction potentials of a novel scatter correction software for bedside chest X‐ray imaging. Radiation Protection Dosimetry 2016;169(1‐4):60–7. Saturday 28 March, 9:30 AM – 11:00 AM Navigating Social Landscapes Binge watching bad TV: Misrepresentation of radiation therapy in the media Victoria Dwyer 1 1 North West Cancer Centre, Burnie, Australia Medical dramas are some of the most widely consumed shows in contemporary television. However, overdramatising and sensationalising storylines for audience consumption results in an inaccurate portrayal of both the radiation therapy (RT) pathway, and the patient experience. Cultivation effect, which explores the relationship between habitual television exposure and a person's beliefs, has shown a positive association between cancer news coverage and fatalistic beliefs about cancer. Similarly, the Grey's Anatomy effect links heavy medical drama watching to false expectations of survivorship. This indicates that prolonged exposure to medical drama plot lines may negatively impact the public perception of RT. Furthermore, an informal literature review was conducted, and findings suggest that up to 27% of patients use the media as an information source to form their understanding of RT, and that this may, in turn, make patients more likely to refuse treatment. 1 Other research suggests that 'the media' generates a negative perception of RT, while experiences of family and friends generate more positive perceptions. 1 In conjunction with the media's ability to influence the opinions of patients and the public, a study also found, through an analysis of The New York Times , that media coverage of RT is becoming more negative, with decreasing coverage of positive stories and increasing coverage of risks, toxicities and errors. 2 This presentation highlights the preconceived bias that patients may hold against RT due to television and media exposure, and the subsequent real‐life impacts of this, through a comedic exploration of the current media landscape. References 1. Gillan C, Abrams D, Harnett N, Wiljer D, Catton P. Fears and misperceptions of radiation therapy: sources and impact on decision‐making and anxiety. J Cancer Educ 2014;29(2):289–95. https://doi.org/10.1007/s13187‐013‐0598‐2 2. Wawrzuta D, Klejdysz J, Chojnacka M. The rise of negative portrayals of radiation oncology: a textual analysis of media news. Radiol Oncol 2024;190:110008. https://doi.org/10.1016/j.radonc.2023.110008 The role of radiography education in advancing the sustainable development goals in the United Nations Haydn Kerr 1 , Shayne Chau 1 , Elio Arruzza 2 , Bismark Ofori‐Manteaw 1 , Kelly Spuur 1 1 Charles Sturt University, Wagga Wagga, Australia, 2 The University of South Australia, Adelaide, Australia Radiography education plays a crucial role in advancing the United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Wellbeing), SDG 4 (Quality Education), and SDG 17 (Partnerships for the Goals). This narrative review explores how radiography education contributes to these goals through curriculum innovation, interdisciplinary collaboration and international partnerships. 1 Radiography directly supports SDG 3 by promoting disease prevention, early detection, and treatment through advances in imaging technologies such as CT and mammography. National initiatives such as BreastScreen Australia highlight how radiography services reduce mortality rates by facilitating early cancer diagnosis and improving access to high‐quality imaging. In alignment with SDG 4, radiography education continues to evolve to meet the demands of modern health care. Curricula increasingly integrate sustainable healthcare principles, digital technologies and innovative pedagogies to ensure graduates are equipped with the skills and adaptability required for a rapidly changing clinical environment. Supporting SDG 17, radiography education fosters global partnerships that promote research collaboration, knowledge exchange and professional capacity building, particularly in low‐ and middle‐income countries where access to imaging education and infrastructure remains limited. Radiography education is vital in achieving the SDGs by preparing healthcare professionals to deliver sustainable, equitable and high‐quality care. Future efforts should prioritise the integration of AI‐enabled learning, remote imaging technologies and strategies that reduce global health disparities. Through these actions, radiography can make a lasting contribution to global health and sustainability. Reference 1. Chau M, Arruzza E, Spuur K, Ofori‐Manteaw B. From classroom to global impact: how radiography education advances the sustainable development goals. Radiography 2025;31(1):224–30. Survival guide to the workplace wilderness: Know your award and enterprise bargaining agreement Marnie Leighton 1 1 Cairns Hospital, Cairns, Australia Understanding enterprise bargaining agreements (EBAs) and industrial awards is essential for all health professionals – but for many, these concepts remain confusing, overlooked or entirely unknown. This presentation explores the importance of embedding award and EBA education into workplace culture, orientation and ongoing professional development. It challenges attendees to consider how well they and their teams understand the frameworks that govern their working conditions. It also explores the broader implications of workplace culture – such as unpaid overtime, skipped breaks and burnout – and how these behaviours can undermine both staff wellbeing and patient care. 1 It also highlights the risks of assuming staff already understand their entitlements, and the long‐term consequences of a workforce that undervalues or misunderstands its industrial rights. 2 This is not a union pitch, but a call to action: to normalise conversations about awards and EBAs, to empower staff with knowledge, and to honour the hard‐won conditions secured by those who came before us. Whether you're a student, new graduate or senior clinician, understanding your industrial rights is not optional – it's essential. References 1. Macdonald F. Short changed: unsatisfactory working hours and unpaid overtime [Internet]. The Australia Institute, 2023. Available at https://futurework.org.au/?p=1717 2. Fair Work Commission. Health Professionals and Support Services Award 2020 [Internet]. Available at https://www.fairwork.gov.au/employment‐conditions/awards Menopause and the challenge of caring in the caring profession Tanya Morgan 1 1 The Australian Society of Medical Imaging and Radiation Therapy, Melbourne, Australia Menopause is a natural mid‐life transition marked by vasomotor symptoms, sleep disturbance, cognitive change and mood variability that can impair daily functioning. 1 Despite affecting over half the population, it remains stigmatised and one of the last ‘unspoken’ issues in workplaces. In Australia, medical radiation practitioners form a predominantly female workforce (approximately 70%), with around 23% aged 40–59 years – the typical peri‐menopausal and menopausal age range – making this a significant workforce wellbeing issue. 2 Evidence from current literature and the Australian Senate Inquiry links menopausal symptoms to reduced concentration, absenteeism, presenteeism and negative career impacts, particularly where organisational culture lacks understanding and support. 3,4 For healthcare professionals, these challenges are compounded by the emotional, cognitive and physical demands of caring roles, which can intensify fatigue, stress and burnout. 5 Creating menopause‐friendly workplaces is essential to retain an experienced, compassionate and resilient workforce. Evidence‐based strategies include developing clear menopause policies and manager training; embedding menopause within leave and wellbeing provisions; offering flexible work arrangements; optimising environmental conditions (e.g. temperature control, rest spaces); and providing confidential access to support and evidence‐based health information. 1,6 This presentation explores the evidence, workforce implications and practical approaches to support medical radiation practitioners experiencing menopause. It is a call to action – to open dialogue, challenge stigma and advocate for the creation of healthcare workplaces that truly care for their carers in the caring profession. References 1. Australasian Menopause Society. 2022. Menopause and the workplace. Available at https://www.menopause.org.au/health‐info/fact‐sheets/menopause‐and‐the‐workplace 2. Medical Radiation Practice Board of Australia. 2025. Statistics [Internet]. Available at https://www.medicalradiationpracticeboard.gov.au/News/Statistics.aspx 3. Faubion SS, Enders F, Hedges MS, et al. Impact of menopause symptoms on women in the workplace. Mayo Clin Proc 2023;98(6):833–45. https://doi.org/10.1016/j.mayocp.2023.02.025 . 4. Parliament of Australia. 2024. Issues related to menopause and perimenopause [Internet]. Available at https://parlinfo.aph.gov.au/parlInfo/download/committees/reportsen/RB000290/toc_pdf/Issuesrelatedtomenopauseandperimenopause.pdf 5. Duggan R, Reid J. 2024. Menopause in the workplace – Australian College of Nursing [Internet]. Available at https://www.acn.edu.au/nurseclick/menopause‐in‐the‐workplace 6. Davis J. 2025. Navigating menopause in the Australian workplace: essential policies for a supportive environment ‐ menopause mastery [Internet]. Available at https://mlrb.net/menopause‐workplace‐policy‐australia Professional button pushers: Podcasting to the undergraduate medical radiation student Tarni Nelson 1,2,3 1 Charles Sturt University, Port Macquarie, Australia, 2 John Hunter Hospital, Newcastle, Australia, 3 Queensland University of Technology, Brisbane, Australia Introduction: The researcher of this study identified a gap in the current availability of educational resources that are specifically designed for the undergraduate student studying medical radiation science. This presentation explores the implementation of an extracurricular podcast to a large undergraduate medical radiation science cohort. Method: The design of this study is observational in that the work presented here is aimed at documenting an innovation in undergraduate education, comparing data from deployment of the podcast in 2021 until currently, 2025. In this study, purposeful sampling was used for the identification and selection of information‐rich cases for the most effective use of limited resources. 1 A total of seven clinical contacts were asked to be informally interviewed on the podcast in its infancy in 2021, with 17 total episodes to date in October 2025, ranging from national contacts to international clinical connections. Results: Analysis of 2021 pilot versus 2025 qualitative and quantitative data sets was undertaken. 2 The results presented is platform, analytical data alongside student and colleague feedback. Results demonstrate the growth and adaptation of the podcast from infancy to its current iteration assessing geographical location of listeners; daily plays of episodes and the listening platforms utilised. Discussion/Conclusion: Positive conclusions have been drawn from the implementation of this emerging innovative digital learning tool with the medical radiation science undergraduate program, including student engagement and excitement, preparation for clinical placement and industry insight. References 1. Patton MQ. Qualitative research and evaluation methods. 3rd edn. Thousand Oaks, CA: Sage Publications; 2002. 2. Nelson T. Professional button pushers. 2025. Available at https://creators.spotify.com/pod/profile/tarni‐nelson/ Saturday 28 March, 9:30 AM – 11:00 AM Digital Learning Journeys Adapting radiography education for new technological challenges: Aligning digital capability with updated MRPBA professional capabilities Jane Caldecutt 1 , Clare Singh 1 1 Charles Sturt University, Wagga Wagga, Australia Rapid digitisation is transforming health care, reshaping professional roles and responsibilities. Radiology has long led this shift, with solutions such as radiology information systems and picture archive communication systems in use for decades. More recently, the rise of electronic medical records has accelerated digital literacy across clinical disciplines, prompting the development of digital capability frameworks in medicine, nursing, midwifery and allied health. However, despite aspects common with radiology, these frameworks often overlook the unique complexities of medical imaging. As a result, there is no agreed standard for digital competency among medical radiation practitioners or consistency across Australian university programs. The 2026 Medical Radiation Practice Board of Australia consultation on professional capabilities signals a shift in expectations regarding the comprehension of health informatics and data management. These revised capabilities will require students to demonstrate knowledge beyond image acquisition, and should include the understanding of digital systems, interoperability standards, data governance and analytics and legislative compliance. This presentation explores current frameworks through a diagnostic radiography lens, identifying gaps and opportunities. It proposes the foundation for a dedicated digital capability framework tailored to medical radiation science. Such a framework would support educators and guide medical radiation science curriculum development to reflect current and emerging technologies and standards within a patient‐centred digital health ecosystem. A framework would also provide a pathway for practitioner career enhancement and advancement in the context of digital health; formalise postgraduate education and empower practitioners meaningfully contribute to enterprise‐wide digital health initiatives. Promoting patient‐centred care through simulation in radiography education Frances Gray 1 , Yobelli Jimenez 1 1 The University of Sydney, Sydney, Australia Introduction: Patient‐centred care is a core professional capability in diagnostic radiography, requiring students to integrate empathy, communication and ethical practice alongside technical competence. However, the pressures of clinical environments can limit opportunities for learners to develop these skills in a supportive, reflective setting. Simulation‐based education (SBE) offers a safe and structured environment to explore patient‐centred interactions and decision‐making before students enter placement. Objective: To describe how simulation scenarios embedded in a radiography curriculum can foster students’ understanding and demonstration of patient‐centred care principles. Methods: A series of high‐fidelity simulations were designed for undergraduate radiography students, focussing on communication, consent, comfort, dignity and emotional support across varied patient presentations (e.g. anxiety, pain, cognitive impairment). Scenarios were followed by structured debriefing using the PEARLS and Gibbs frameworks, enabling guided reflection on behaviours and values. Student reflections, facilitator observations, and pre‐ post‐questionnaires were thematically analysed to evaluate perceived learning outcomes. Results: Students reported increased confidence in engaging empathetically with patients, managing challenging emotional encounters, and balancing clinical efficiency with compassion. Qualitative analysis demonstrated growth in self‐awareness, teamwork and the ability to adapt communication to individual patient needs. Conclusion: Simulation provides a powerful pedagogical approach to develop patient‐centred competencies prior to clinical placement. Embedding structured reflection and debriefing within simulated radiography experiences supports the translation of empathy and professionalism from the classroom to clinical practice. Enhancing the preparation of first‐year students through the use of live‐streaming clinical teaching sessions Jane Harvey‐Lloyd 1 1 University of Leeds, Leeds, United Kingdom Introduction: Virtual clinical experience (VCE) technology enables the live‐streaming of clinical suite teaching sessions through the use of ‘smart glasses’. VCE allowed lecturers to not only teach radiographic technique to a group of eight to 10 students in person but also to live‐stream the sessions to the wider group remotely, allowing direct communication. This project evaluated the experience of student learning through the facilitated use of smart glasses in the clinical skill suites sessions. Method: Following the delivery of the radiographic practical teaching sessions, they were invited to take part in this study by completing an online questionnaire. The aim of the questionnaire was to evaluate their experience of the sessions using 17 5‐point Likert‐scale questions. Two open questions were used at the end of the questionnaire to allow for qualitative comments from the students. Results: There was a 51% response rate. The Likert‐rated statements were quantitatively analysed, and themes were identified from the open questions responses. Conclusion: Positive aspects were identified as: the VCE enhanced links between theory and practice, there was good engagement with the online moderator, the students were able to view the radiographic technique from different perspectives, and students felt included. Less positive aspects were the navigation of the VCE platform, students were unsure as to how the use of VCE could be expanded in future teaching sessions, and there was a need for further training. Navigating digital transformation: Co‐creating safe, sustainable radiation safety systems in higher education John Ryan 1 , John McInerney 1 1 Monash University, Melbourne, Australia Medical radiation departments in higher education face increasing complexity in meeting radiation safety, legislative and administrative requirements across multiple teaching sites. Consultation with academic, technical and professional staff identified the need for a consistent, efficient and transparent approach to safety management. Management processes were transformed through the creation of a centralised digital radiation safety hub on a university intranet platform (SharePoint, Microsoft), providing a single source of truth for all safety documentation, processes and equipment records. Complementary digital tools, including a personal dosimeter management app and a laboratory induction app, formalised workflows, improved accessibility and supported equitable participation for staff and students regardless of location. Automated reminders and real‐time compliance tracking using business intelligence software (Power BI, Microsoft) strengthened personal accountability, reduced administrative burden and minimised late fees previously incurred through delayed returns to the regulating authority. With over 1200 dosimeters issued annually across 25 orders, this centralised system has been essential for maintaining compliance, improving efficiency and enhancing safety outcomes. Since implementation, compliance with personal dosimeter management has improved markedly. Collectively, these initiatives have created safer learning environments, more efficient workflows and a stronger safety culture. By listening to user needs, adapting legacy processes and discovering digital solutions, the radiation safety team has established a scalable model of excellence that can be replicated across the higher education sector. Overview of medical radiation students and graduates artificial intelligence readiness for clinical practice and integration Ajesh Singh 1 , Andrew Murphy 2 , Chris Edwards 1 , Crispen Chamunyonga 1 , Chandra Makanjee 3 , Elio Arruzza 4 , Therese Gunn 1 1 Queensland University of Technology, Brisbane, Australia, 2 Queensland Children's Hospital, Brisbane, Australia, 3 The University of Canberra, Bruce, Australia, 4 The University of South Australia, Adelaide, Australia Introduction: The evolving complex artificial intelligence (AI) technology in medical imaging is no longer a prospect, with applications among other spanning across image acquisition and optimisation, reconstruction, dose‐optimisation and interpretation. 1 The Medical Radiation Practice Board of Australia (MRPBA) 2 highlights the need for practitioners to maintain control over AI‐supported technologies to ensure safe clinical use. Educational institutions must lead in equipping future medical imaging professionals with the knowledge, skills and clinical experience needed to work effectively with AI. This study explores the level of readiness of final‐year students and graduate professionals' knowledge and competencies in AI technology. Methods: This study entailed cross‐sectional survey. Eligible participants were Australian final‐year students or recent graduates (≤18 months post‐qualification) from accredited Australian medical radiation science programs. The questionnaire entailed demographic questions, 22 questions from the validated MAIRS‐MS tool and open‐ended item response. Survey was administered using QualtricsXM. Results: Data collection is currently in progress. It is anticipated that this study will inform on current trends on of AI content /knowledge integration in course offerings, the level of preparedness and impact on AI integrated medical imaging practice contexts. Discussion: The discussion will be based on the findings. It is envisaged that the current study will inform curriculum development and continuing professional education strategies, to better align with the MRPBA's recommendations for safe and effective AI integration. Conclusion: A baseline profile to inform on curriculum design and workplace place requirements in alignment with the regulatory AI‐related MRPBA's professional capabilities framework. References 1. Doshi A. AI in daily neuroradiology practice. RSNA News. Radiological Society of North America; 2025. Available at https://www.rsna.org/news/2025/july/ai‐in‐daily‐neuroradiology‐practice 2. Medical Radiation Practice Board of Australia. 2022. Statement on artificial intelligence in medical radiation practice. Available at https://www.medicalradiationpracticeboard.gov.au/Registration‐Standards/Statement‐on‐Artificial‐Intelligence.aspx Saturday 28 March, 9:30 AM – 11:00 AM Advancing Breast Care Cutting the cake: Optimising arc and collimator design in comprehensive nodal VMAT breast radiotherapy Laura Baker 1 , Andrew Le 1 , Regina Bromley 1 , Susan Carroll 1 , John Atyeo 1 1 Northern Sydney Cancer Centre, Sydney, Australia Introduction: As breast radiotherapy moves toward ultra‐hypofractionation, adapting standard techniques is essential. Volumetric modulated arc therapy (VMAT) for comprehensive nodal involvement raises concerns about low‐dose exposure to organs at risk (OAR). Our department re‐evaluated large‐arc VMAT approaches to align with international data, 1 focussing on minimising exit doses to the heart, contralateral breast and lungs. This study assesses the impact of shorter arc trajectories combined with collimator angle optimisation on OAR sparing. Methods: 20 patients treated on a Varian TrueBeam with three continuous VMAT arcs (220° trajectory) were retrospectively replanned. The prescribed dose was 26 Gy in 5 fractions to the breast, lymph nodes and internal mammary chain, with a simultaneous integrated boost of 28–30 Gy. New arcs were segmented with optimised collimator angles tailored to each patient's volume (Fig. 1). Results: Modification of VMAT arcs with tailored collimator angles significantly reduced dose to OAR without compromising coverage. Mean dose to heart, contralateral beast and contralateral lung decreased by 6%, 2.5% and 12.63%, respectively. Contralateral V10% also decreased by 24.4%. Collimator optimisation did not significantly affect ipsilateral mean or V10% dose. Split arc plans averaged 1.7 arcs versus three in original plans, reducing treatment time and improving patient comfort. Additionally, five shorter fields enhanced deep inspiration breath hold compliance. Conclusion: With recent evidence linking internal mammary node radiotherapy to improved overall survival, 2 developing safe, effective delivery techniques for ultra‐hypofractionated nodal radiotherapy is a key clinical focus. This approach demonstrates adapting to new data and refining strategies for comprehensive nodal breast radiotherapy. References 1. Kim N, Chang JS, Shah C, et al. Hypofractionated volumetric‐modulated arc therapy for breast cancer: a propensity‐score‐weighted comparison of radiation‐related toxicity. Int J Cancer 2021;149(1):149–57. 2. Nielsen AW, Thorsen LBJ, Özcan D, et al. Internal mammary node irradiation in 4541 node‐positive breast cancer patients treated with newer systemic therapies and 3D‐based radiotherapy (DBCG IMN2): a prospective, nationwide, population‐based Cohort Study. Lancet Regional Health ‐ Europe 2025;49:101160. https://doi.org/10.1016/j.lanepe.2024.101160 Reducing the burden of bone health monitoring in women with breast cancer: A pilot study Fay Manning 1,2 , Matthew G Wallis 2 , Ben Lopez 3 , David Joyce 3 , Nuala Healy 2 1 University of Exeter, Exeter, United Kingdom, 2 Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom, 3 IBEX Innovations Limited, Durham, United Kingdom Introduction: Women diagnosed with breast cancer treated with aromatase inhibitors are at higher risk of fracture and osteoporosis. Guidelines mandate monitoring with dual‐energy X‐ray absorptiometry (DXA), however DXA wait times and additional visits adds burden to patients. This study pilots a novel intervention, IBEX BH software, which can predict fracture risk from wrist X‐rays undertaken on mammography equipment. The study aimed to assess practical feasibility and patients’ acceptability of the intervention. Method: Women with breast cancer awaiting DXA were recruited to include an additional wrist X‐ray as part of their mammography follow‐up appointment. Patients and the attending radiographer were surveyed on their experience. Results: 15 women were recruited. All additional scans were successfully completed and only added 1–2 minutes to the appointment. Correlations between IBEX BH aBMD and DXA femoral neck aBMD indicated technical feasibility. Most participants reported no impact of the additional scan on their appointment (n = 13), and two indicated positive impact. Participants highlighted the benefit of the combined appointments of reduced cost (to themselves and the health service), travel and infection risk. Conclusion: This successful pilot indicates the feasibility and acceptability of a larger clinical study to ensure the clinical validity and suitability of the IBEX BH intervention. There was no evidence to suggest inferior correlation on mammography equipment. This intervention provides an exciting opportunity to improve the care of women with breast cancer and reduce burden on the patient and services. Early multi‐parametric MRI assessment of breast cancer response following single‐fraction neoadjuvant radiotherapy: Feasibility study Ayyaz Qadir 1 , Nabita Singh 1 , Eddie Lau 3,4,5 , Michael Chao 1,2 , Sergio Uribe 1 , Farshad Foroudi 1,2 1 Monash University, Melbourne, Australia, 2 Olivia Newton‐John Cancer Wellness & Research Centre, Heidelberg, Australia, 3 The University of Melbourne, Parkville, Australia, 4 Radiology, Austin Health, Heidelberg, Australia, 5 Department of Molecular Imaging, Austin Health, Heidelberg, Australia Introduction: Single‐fraction neoadjuvant radiotherapy (SF‐NRT) is a promising alternative for patients with low‐risk, early‐stage breast cancer. 1‐8 However, the optimal post‐treatment interval for response assessment remains undefined. This study evaluated the feasibility of multi‐parametric MRI (mp‐MRI) for detecting early changes after SF‐NRT within a single‐arm MRI‐guided single‐fraction preoperative radiotherapy for early‐stage breast cancer (RICE) feasibility trial at 5 weeks post‐treatment. Methods: Nine postmenopausal women (median age 69 years) with ER/PR+, grade 1–2 invasive ductal carcinoma ≤20 mm received a single 21 Gy preoperative fraction on the Elekta Unity 1.5 T MR‐linac. MRI (1.5 T Philips Ingenia Ambition) was performed at baseline and 5 weeks post‐treatment. Imaging included diffusion‐weighted (ADC), standard DCE‐MRI with voxel‐wise signal enhancement ratio (SER) mapping and ultrafast DCE analysis. Pathologic response was classified using the modified Miller‐Payne system. Results: Six patients (67%) demonstrated partial pathologic response and three (33%) were non‐responders; none achieved pathological complete response (pCR). Across all patients, ADC increased (0.99 × 10 ‐3 → 1.18 × 10 ‐3 mm 2 /s), with partial responders showing greater percentage rises (+31% vs +19%). SER habitat analysis revealed decreased washout and intermediate‐enhancing voxels and a decline in peak SER (0.98 → 0.83), consistent with vascular normalisation. Tumor morphological and ultrafast parameters displayed minimal differences and large inter‐patient variability. Conclusions: mp‐MRI detected biologically plausible diffusion and perfusion changes 5 weeks after SF‐NRT, distinguishing partial from non‐responders before measurable morphologic regression. Diffusion and SER‐based vascular mapping show promise as early imaging biomarkers, warranting validation in larger cohorts. References 1. Meattini I, Francolini G, Di Cataldo V, et al. Preoperative robotic radiosurgery for early breast cancer: results of the phase II ROCK trial ( NCT03520894 ). Clin Transl Radiat Oncol 2022;37:94–100. 2. Tiberi D, Vavassis P, Nguyen D, et al. Tumour response 3 months after neoadjuvant single‐fraction radiotherapy for low‐risk breast cancer. Curr Oncol 2020;27(3):155–8. 3. Lavigne D, Hijal T, Vavassis P, et al. Single preoperative radiation therapy with delayed surgery for low‐risk breast cancer: oncologic outcome, toxicity and cosmesis of the SPORT‐DS phase I trial. Radiother Oncol 2024;200:110515. 4. Guidolin K, Yaremko B, Lynn K, et al. Stereotactic image‐guided neoadjuvant ablative single‐dose radiation, then lumpectomy, for early breast cancer: the SIGNAL prospective single‐arm trial of single‐dose radiation therapy. Curr Oncol 2019;26(3):e334–e40. 5. Vasmel JE, Charaghvandi RK, Houweling AC, et al. Tumor response after neoadjuvant magnetic resonance guided single ablative dose partial breast irradiation. Int J Radiat Oncol Biol Phys 2020;106(4):821–9. 6. Rahimi A, Simmons A, Kim DN, et al. Preliminary results of multi‐institutional phase 1 dose escalation trial using single‐fraction stereotactic partial breast irradiation for early stage breast cancer. Int J Radiat Oncol Biol Phys 2022;112(3):663–70. 7. Horton JK, Blitzblau RC, Yoo S, et al. Preoperative single‐fraction partial breast radiation therapy: a novel phase 1, dose‐escalation protocol with radiation response biomarkers. Int J Radiat Oncol Biol Phys 2015;92(4):846–55. 8. Qadir A, Singh N, Dean J, et al. Magnetic resonance imaging‐guided single‐fraction preoperative radiotherapy for early‐stage breast cancer (the RICE trial): feasibility study. Pilot and Feasibility Studies 2024;10(1):133. Dense tissue, clear responsibility: Elevating technologist advocacy in breast imaging Todd Van Auken 1 1 St Petersburg College, Florida, United States Dense breast tissue presents one of the most persistent challenges in diagnostic imaging, yet many patients remain unaware of its implications and many technologists are underprepared to act as advocates. This presentation reframes the conversation around dense tissue detection by centring technologist advocacy as an essential tool for prevention, early detection and patient empowerment. Through a real‐world example, international policy comparisons and practical strategies, attendees will explore how radiologic technologists can, and must, step beyond the imaging console to promote patient understanding and timely follow‐up. The session highlights how advocacy skills can be integrated into clinical workflows, how technologists can influence institutional and national improvements, and how imaging professionals can serve as frontline defenders against diagnostic delays. Attendees will leave equipped with actionable strategies, tools for effective communication and a renewed sense of purpose in shaping patient outcomes, especially when the image is not clear. Saturday 28 March, 9:30 AM – 11:00 AM Enhancing Clinical Practice (RT) Going beyond organ at risk: Target delineation education aimed at radiation therapists Linda Bell 1 , Carlito Coronel 1 , Shaun Sae‐Lieo 1 , Craig Opie 1,2,3 , Alannah Kejda 1 , Thomas Eade 1,4 , George Hruby 1,4 , Andrew Kneebone 1,4 , Patrick Horsley 1,4 , Brian Porter 1 1 Northern Sydney Cancer Centre, St Leonards, Australia, 2 Charles Sturt University, Wagga Wagga, Australia, 3 Monash University, Melbourne, Australia, 4 The University of Sydney, St Leonards, Australia Introduction: Radiation therapist (RT)‐led adaptive radiotherapy requires RTs to delineate target volumes without the supervision of a radiation oncologist. 1 This has required the development of a target delineation education program. Methods: A team of independent RTs developed a target and organ at risk contouring atlas and a cone beam CT (CBCT) contouring package for definitive and post‐prostatectomy prostate cancer. The atlas was developed in collaboration with the genitourinary radiation oncologists, referencing consensus guidelines. Deliberate education design was employed to package information for advanced RT end users, incorporating visual and descriptive aids. The contouring program utilised 20 de‐identified definitive prostate CBCT and 15 post‐prostatectomy CBCT from previously adapted fractions containing gold standard radiation oncologist approved contours and corresponding reference planning scans. Contouring was completed on CBCT scans using Eclipse (Varian). Results: Three adaptive RTs participated, with each RT given access to the contouring atlas as a self‐education tool. The contouring cases were released in three stages with feedback provided individually to each RT (Fig. 1). The RTs were able to provide feedback on the package and changes were made for the next iteration of the package. The package was then made available to a further two adaptive RTs. Conclusion: A target contouring education program for RTs has been successfully implemented through a multi‐disciplinary approach and deliberate packaging of material for bespoke education of RTs. Given the successful implementation of the program, extending the education for standard of care training and advancement is being considered. Reference 1. Goudschaal K, Azzarouali S, Visser J, et al. Clinical implementation of RTT‐only CBCT guided online adaptive focal radiotherapy for bladder cancer. Clin Transl Radiat Oncol 2025;50:100884. Evaluating the impact of a palliative care advanced practice radiation therapist in radiation oncology Danielle Duff 1 , Christopher Harrington 1 , Melissa James 1 , Philippa Daly 1 1 Te Whatu Ora Waitaha – Health New Zealand, Canterbury, New Zealand Introduction: Access to timely palliative radiotherapy is a persistent challenge in oncology services, exacerbated by rising demand, workforce constraints and complex patient needs. 1‐4 To address these pressures, a New Zealand regional cancer service piloted an advanced practice radiation therapist (APRT) specialising in palliative care. Such roles, validated internationally but not yet adopted in New Zealand, have been shown to streamline care, support radiation oncologists and improve access and outcomes. 5‐13 Methods: A 12‐month pilot (2023–2024) established and evaluated a palliative APRT role under radiation oncologist supervision. Responsibilities included first specialist appointments, clinical coordination, contouring, planning and pathway optimisation. Activities were recorded in a service log and aligned with structured competency training and a master's‐level program. Evaluation focussed on care timelines, radiation oncologist time savings, pathway efficiency, qualitative feedback and systemic service improvements. Results: The APRT role reduced wait times by 3–6 weeks, shortened radiation oncologist first specialist appointment consultations from 1 hour to 15 minutes, and enabled same day workup, simulation and treatment in urgent cases. APRT‐facilitated planning allowed radiation oncologist review and approval in under 10 minutes. Coordination improved for complex and rural patients, while reducing hospital stays. Several patients were removed from harm registers and service development projects – including SIMLESSRT pathway implementation – were advanced. Conclusion: The APRT role enhanced timeliness, coordination and efficiency, enabling task‐shifting and improving patient outcomes. Findings support ongoing integration, national scaling and credentialling of APRT roles. References 1. He Mahere Ratonga Mate Pukupuku Cancer Services. 2022. Planning a vision for cancer treatment in the reformed health system. Wellington: Te Aho O Te Kahu; 2021. 2. Ministry of Health. 2016. Health loss in New Zealand 1990–2013: a report from the New Zealand Burden of Diseases, Injuries and Risk Factors Study. Available at https://www.health.govt.nz/publication/health‐loss‐new‐zealand‐1990‐2013 3. Ministry of Health. 2019. New Zealand Cancer Action Plan 2019–2029 – Te Mahere mō te Mate Pukupuku o Aotearoa 2019–2029. Revised January 2020. 4. Kain M, Bennett H, Yi M, Robinson B, James M. 30‐day mortality following palliative radiotherapy. J Med Imaging Radiat Oncol 2020;64(4):570–99. https://doi.org/10.1111/1754‐9485.13073 5. Job M, Holt T, Bernard A. An evaluation of an advanced practice role in palliative radiation therapy. J Med Radiat Sci 2019;66(2):96–102. https://doi.org/10.1002/jmrs.318 6. Dennis K, Harris G, Kamel R, et al. Rapid access palliative radiotherapy programmes. Clin Oncol (R Coll Radiol) 2020;32(11):704–12. https://doi.org/10.1016/j.clon.2020.08.002 7. Lavergne C, Rozanec N, Harnett N. The palliative clinical specialist radiation therapist: a CAMRT white paper. J Med Imaging Radiat Sci 2021;52(4):636–49. https://doi.org/10.1016/j.jmir.2021.08.016 8. Rozanec N, Lavergne C, Harnett N. A Canadian experience of palliative advanced practice radiation therapy TIPS: training, implementation, practice and sustainability. Tech Innov Patient Support Radiat Oncol 2021;17:89–96. https://doi.org/10.1016/j.tipsro.2021.01.003 9. The Royal Australian and New Zealand College of Radiologists. 2022.Training Requirements (Radiation Oncology) Policy, Version 1.0. Appendix 1: Acknowledgments & Document Review. 10. Roos D, Job M, Holt T. Establishing a palliative advanced practice radiation therapist role: a viable alternative to a rapid access palliative radiation therapy clinic in Australia. J Med Imaging Radiat Oncol 2022;66(1):117–28. https://doi.org/10.1111/1754‐9485.13332 11. Wong SMM, Sin SY, Lim LH, et al. The implementation of an advanced practice radiation therapy (APRT) program in Singapore. Tech Innov Patient Support Radiat Oncol 2021;17:63–70. https://doi.org/10.1016/j.tipsro.2021.02.002 12. Rozanec N, Lavergne C, Harnett N. A Canadian experience of palliative advanced practice radiation therapy TIPS: training, implementation, practice and sustainability. Tech Innov Patient Support Radiat Oncol 2021;17:89–96. https://doi.org/10.1016/j.tipsro.2021.01.003 13. Wright C, Matthews K. An intentional approach to the development and implementation of meaningful assessment in advanced radiation therapy practice curricula. Tech Innov Patient Support Radiat Oncol 2022;24:13–8. https://doi.org/10.1016/j.tipsro.2022.08.010 Experience and perceptions of inaugural advanced practice radiation therapy roles: Benefits, challenges and evolving impact Rebecca Height 1 , Kristie Matthews 2 1 Peter MacCallum Cancer Centre, Melbourne, Australia, 2 Monash University, Melbourne, Australia Introduction: Advanced practice radiation therapists (APRTs) enhance care quality and clinical efficiency in radiation oncology. This study explored the experiences and perceptions of APRTs, their supervisors, managers and colleagues regarding the benefits a challenges and sustainability of advanced practice roles within a new model of care. Method: A longitudinal mixed methods approach incorporating interviews and surveys were conducted with APRTs, radiation oncologists (ROs) supervisors, service directors and managers and other colleagues at 0‐, 6‐, 12‐ and 18‐months post‐implementation. Participation was voluntary. Data was analysed to identify themes related to clinical, educational and organisational impact. Results: All APRTs, RO supervisors and service managers/directors participated in interviews (n = 20) at 6‐ and 12‐months post‐implementation. Surveys at 6‐, 12‐ and 18‐months attracted 24, 39 and six respondents, respectively. APRTs were perceived to streamline patient pathways, expedite RO procedures and support RT upskilling. They enhanced multi‐disciplinary collaboration, bridged knowledge and skill gaps between ROs and RTs and promoted integration. APRTs were recognised for leading innovation, research and education, driving measurable improvements through new protocols and clinical techniques. Structured training and RO mentorship were critical to early development and independent practice. A key benefit identified was saving RO time through task delegation, reducing workflow interruptions and supporting focussed decision‐making. Sustaining roles remains challenged by funding constraints, workload prioritisation and succession planning. Conclusion: APRTs deliver measurable clinical and organisational benefits. Ongoing mentorship, structured development pathways and sustainable investment are essential to maintain and expand these roles, ensuring continued improvements in care quality and service efficiency. Care path review of an advanced practice palliative radiation therapy role Tahira Peer 1 , Scott Jones 1 , Mary Job 1 , Tessa Davidson 1 , Natalia Mitina 1 , Luke Nicholls 1 , Tanya Holt 1 , Ruth Pethybridge 1 1 Princess Alexandra Hospital Raymond Terrace, Brisbane, Australia Introduction: The palliative advanced practice radiation therapy (APRT) role is well established at Radiation Oncology Princess Alexandra Hospital Raymond Terrace (ROPART) with over 10 years of service integration. To describe a contemporary picture of how the role has evolved and the impact it has on service delivery, we sought to design a visual care path diagram that would describe the clinical scope of the APRT role compared to a standard care path and lay the foundation for a broader economic evaluation. Methods: A participatory co‐design method was employed to develop a care path diagram similar to the work by Defourny et al. 1 Representatives from each discipline involved in palliative patient care at ROPART were interviewed to understand their perspective on typical care delivered. Themes and key tasks from these discussions were identified and used to form a detailed diagram of care points and tasks, with disciplines allocated to each task. The final diagram and description of tasks were agreed on in consensus between discipline representatives. Results: A care path diagram was developed describing four key points of care from referral to completion of planning. It was determined that while the tasks performed were identical between the APRT and non‐APRT care paths, discipline involvement varied between the two, with the APRT role performing or supplementing many of the radiation oncologist's tasks. Conclusion: The detailed visual description of the care path differences highlights how far the APRT role has evolved and provides the foundation for an economic value assessment. Reference 1. Defourny N, Hoozée S, Daisne JF, Lievens Y. Developing time‐driven activity‐based costing at the national level to support policy recommendations for radiation oncology in Belgium. J Account Public Policy 2023;42(10):107013. https://doi.org/10.1016/j.jaccpubpol.2022.107013 Experience implementing surface guided radiation therapy for VMAT total body irradiation: Our discovery and adaptation Rachel O'Meara 1 , Angela Viotto 1 , Jarrod Prohasky 1 1 Olivia Newton‐John Cancer Wellness & Research Centre, Heidelberg, Australia Introduction: Surface guided radiation therapy (SGRT) was integral to the safe and efficient implementation of volumetric modulated arc therapy (VMAT) for total body irradiation (TBI). This presentation outlines our discovery and adaptation in developing an effective SGRT workflow for this complex technique. Background: VMAT TBI offers improved dose homogeneity and organ at risk sparing compared to conventional methods. 1 Therefore, this technique requires precise reproducible full‐body positioning and continuous monitoring. Early setup processes relied on extensive landmarking, tattoos and manual reference line checks to ensure reproducibility. With the introduction of SGRT, these manual methods were replaced by real‐time surface tracking, providing whole‐body verification from head to toe and streamlining patient setup. A combined workflow integrating SGRT, with pre‐treatment cone beam CT (CBCT) and 2D kV, and a rotatable tabletop further simplified transitions between head‐first and feet‐first orientations, enhancing both accuracy and efficiency. Discussion: Initial clinical experience demonstrated that SGRT improved workflow efficiency, reduced treatment times and enhanced patient comfort. It proved particularly valuable in monitoring regions outside the CBCT field of view and detecting subtle body contour changes requiring intervention. Continuous intra‐fraction motion monitoring reduced immobilisation needs in areas such as fingers and toes, where constructing effective immobilisation is challenging. Conclusion: Integrating SGRT into VMAT TBI established a reproducible, accurate and patient‐centred workflow within clinically feasible timeframes. These findings highlight SGRT as a critical enabler of safe, precise and patient‐focussed TBI delivery and a foundation for continued innovation. Reference 1. Hui C, Simiele E, Lozko Y, et al. Volumetric modulated arc therapy total body irradiation improves toxicity outcomes compared to 2D total body irradiation. Front Oncol 2024;(16)14:1459287. https://doi.org/10.3389/fonc.2024.1459287 Development and utilisation of a secure application for transfer of previous radiation therapy treatment details Kenton Thompson 1,2 , Phillip Moloney 3 , Nigel Cristofaro 4 , Drew Smith 5 , Vanessa Panettieri 1,2 1 Peter MacCallum Cancer Centre, Melbourne, Australia, 2 Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia, 3 Andrew Love Cancer Centre, Geelong, Australia, 4 GenesisCare, Melbourne, Australia, 5 Olivia Newton‐John Cancer Wellness & Research Centre, Heidelberg, Australia Introduction: A complete history of a patient's previous radiation treatments including Digital Imaging and Communications in Medicine (DICOM) data is essential to confirm the safety of re‐irradiation. 1 However, data availability and transfer remains a major challenge, 2 particularly when patients move between providers. We aim to describe the development of a dedicated secure file transfer system (Patient Document eXchange, PDX) for all Victorian radiation therapy providers (public and private) and its pattern of utilisation. Methods: Project reports and correspondence were accessed to evaluate the development of PDX. Monthly reports were used to assess the number, type and timeliness of data transfers. Ethical approval was not required. Results: In the 5 years from the 16 March 2020 to 28 February 2025 there were 3911 requests for previous treatment details not including cancelled requests. Of these, 2937 (75%) requests involved transfer of DICOM. Requests for previous treatment details have increased over time with a noticeable increase when the private radiation therapy providers joined (July and August 2021). Of the 3911 requests, 2724 were standard requests (requesting information within 2 days) and 1187 urgent requests (requesting information within 1 day). Figure 1 shows the days to respond. Conclusion: PDX was developed for secure and timely requesting and transfer of previous treatment details. Utilisation demonstrates that PDX has addressed a major challenge with DICOM now routinely shared, and most requests responded to in a timely manner. References 1. Andratschke N, Willmann J, Appelt AL, et al. European Society for Radiotherapy and Oncology and European Organisation for Research and Treatment of Cancer consensus on re‐irradiation: definition, reporting, and clinical decision making. Lancet Oncol 2022;23(10):e469–78. 2. Andratschke N, Willmann J, Appelt AL, et al. Reirradiation− still navigating uncharted waters? Clin Translation Radiat Oncol 2024;100871. Saturday 28 March, 9:30 AM – 11:00 AM Ultrasound (MI) Pre‐scan informedness and anxiety during the 20‐week morphology ultrasound: A prospective mixed‐methods study Mandy Feng 1 , Ignatius Pereira 1 , Jerome Boyle 2 1 Monash University, Clayton, Australia, 2 Imaging Associates Radiology, Melbourne, Australia Introduction: The 20‐week morphology ultrasound is a critical milestone in antenatal care, combining diagnostic assessment with an opportunity for parental bonding. 1 While often reassuring, it can also provoke significant maternal anxiety. 2 The primary aim of this study was to examine the relationship between pre‐scan informedness and maternal anxiety prior to the 20‐week morphology ultrasound. Secondary objectives included exploring associations between patient type (public vs private), cost expectations, and pregnancy complications to identify predictors of patient experience. Despite the importance of informedness in shaping emotional and practical preparedness, evidence within the Australian context remains limited. Methods: A prospective cross‐sectional survey was conducted with 78 antenatal patients prior to their 20‐week morphology scan. A 17‐item questionnaire collected data on demographics, pregnancy history, complications, informedness, anxiety and cost expectations. Associations were examined using Spearman's rank correlation and ordinal regression (adjusting for age, parity and complications). Secondary analysis used chi‐square tests to assess relationships between patient type and cost expectations. Ethics approval was obtained. Results: Higher informedness was significantly associated with lower pre‐scan anxiety (ρ = –0.26, p = 0.024). Regression confirmed informedness as an independent predictor of reduced anxiety (β = ‐0.30, p = 0.009), while pregnancy complications were linked to increased anxiety (p = 0.012). Private patients were more likely than public patients to anticipate out‐of‐pocket costs (χ 2 (1) = 14.82, p < 0.001). Conclusion: Pre‐scan informedness is a modifiable factor that reduces maternal anxiety during the 20‐week morphology ultrasound. Structured pre‐scan education and transparent communication of financial expectations may optimise patient experience and promote patient‐centred antenatal care. References 1. Dogan Y, Kockaya E, Eser MD, Daryal AS. Pregnant women's background knowledge, expectations and attitude about second trimester detailed ultrasound scan. Acta Medica Nicomedia 2023;6(3):395–402. https://doi.org/10.53446/actamednicomedia.1343262 2. Salomon LJ, Alfirevic Z, Berghella V, et al. ISUOG practice guidelines (updated): performance of the routine mid‐trimester fetal ultrasound scan. Ultrasound Obstet Gynecol 2022;59(6):840–56. Upper limb nerves Andrew Grant 1 1 I‐MED, East Melbourne, Australia Ultrasound evaluation of the upper limb nerves has become an essential tool for diagnosing peripheral neuropathies, entrapment syndromes and traumatic nerve injuries. This presentation highlights the anatomy, scanning techniques and sonographic appearance of major upper limb nerves, including the median, ulnar, radial and musculocutaneous nerves. High‐frequency ultrasound allows real‐time visualisation of nerve continuity, fascicular pattern and dynamic assessment during movement, offering superior spatial resolution compared to other imaging modalities. Key pathological findings such as nerve enlargement, altered echotexture, loss of fascicular pattern and changes in vascularity will be discussed. Case examples will illustrate the role of ultrasound in identifying common conditions such as carpal tunnel syndrome, cubital tunnel syndrome and radial nerve entrapment. Retrospective analysis of mobile ultrasound services for Victorian nursing home residents Hoang An Nguyen 1 , Sergio Uribe 1 , Jenny Sim 1 , Ignatius Pereira 1 , Nick Crawford 1 1 Monash University, Melbourne, Australia Introduction: The growing aging population has led to increased use of ultrasound (US) in health care. 1 Mobile US has emerged as a cost‐effective, accessible and safe diagnostic tool, offering substantial benefits for elderly patients in nursing homes. While mobile US is widely implemented in developing countries, 2 it remains underutilised in Australia, with limited evidence on its effectiveness and potential to reduce hospital imaging demand. 3 This retrospective study aimed to estimate the proportion of US scans performed in emergency department (ED) and outpatient settings that could have been avoided through mobile US services for Victorian nursing home residents. Methods: Data from the National Centre for Healthy Ageing included 94 ED and 378 outpatient US cases for nursing home residents at Frankston Public Hospital (2018–2023). Cases were categorised by triage, scan type, discharge destination and transport mode to identify those suitable for mobile US and those that required ED US services. Results: Of 94 ED cases, 17% were urgent and 83% were semi‐urgent or non‐urgent; 21% of these patients were discharged back to nursing homes, indicating suitability for mobile US. Among 378 outpatient USs, 72.6% were routine and considered mobile‐feasible, while 27.4% were interventional and required hospital imaging. Overall, 18% of ED and 72.6% of outpatient scans could have been conducted via mobile US, representing a potential 57.7% reduction in hospital‐based imaging. Conclusions: Expanding mobile US in nursing homes may reduce hospital imaging demand, improve efficiency and enhance patient comfort. Larger, multi‐centre studies are warranted to inform clinical and policy decisions in Australia. References 1. Gaget V, Inacio MC, Tivey DR, et al. Trends in utilisation of ultrasound by older Australians (2010–2019). BMC Geriatrics 2023;23(1):50. https://doi.org/10.1186/s12877‐023‐03771‐y 2. Stewart KA, Navarro SM, Kambala S, et al. Trends in ultrasound use in low and middle‐income countries: a systematic review. Int J MCH AIDS 2020;9(1):103–20. https://doi.org/10.21106/ijma.294 3. Shaddock L, Smith T. Potential for use of portable ultrasound devices in rural and remote settings in Australia and other developed countries: a systematic review. J Multidiscip Healthc 2022;15:605–25. https://doi.org/10.2147/JMDH.S359084 Ultrasound and other imaging for diagnosis of nutcracker syndrome and associated symptoms Ming Tan 1,2 1 Precise Radiology, Carnegie, Australia, 2 Western Health, Sunshine, Australia Introduction: Nutcracker syndrome (NCS) is a type of vascular compression syndrome. It is uncommon and likely underdiagnosed, which can lead to severe complications. 1 NCS is caused by compression of the left renal vein (LRV), either between the abdominal aorta and the superior mesenteric artery or between the aorta and the vertebral body. This results in increased pressure in the LRV and can lead to haematuria. 2 The clinical presentation of NCS is variable and may include flank pain, haematuria, proteinuria, varicocele, varices, dysmenorrhea and, less commonly, hypotension and tachycardia. 3 Discussion: Doppler ultrasound is commonly used for the diagnosis of NCS and associated conditions, such as varicocele. Computed tomography angiography and magnetic resonance angiography can also be used to diagnose or confirm the presence of NCS. 4 The diagnosis of NCS involves measurement of the angle between the abdominal aorta and the superior mesenteric artery, evaluation of changes in the diameter and velocity of the LRV at the compression site, and identification of the ‘beak sign’ on CT/MRI angiography. Conclusion: Improved knowledge of NCS and its diagnostic criteria can lead to a higher detection rate, resulting in better prognosis and more appropriate management and timely treatment for patients with NCS. 5 References 1. Penfold D, Leslie SW, Lotfollahzadeh S. Nutcracker syndrome and left renal vein entrapment. 2024 May 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. 2. Gulleroglu K, Gulleroglu B, Baskin E. Nutcracker syndrome. World J Nephrol 2014;3(4):277–81. 3. Dunphy L, Penna M, Tam E, El‐Kafsi J. Left renal vein entrapment syndrome: nutcracker syndrome! BMJ Case Rep 2019;12(9). 4. Kim SH. Doppler US and CT diagnosis of nutcracker syndrome. Korean J Radiol 2019;20(12):1627–37. https://doi.org/10.3348/kjr.2019.0084 5. Ananthan K, Onida S, Davies AH. Nutcracker syndrome: an update on current diagnostic criteria and management guidelines. Eur J Vasc Endovasc Surg 2017;53(6):886–94. https://doi.org/10.1016/j.ejvs.2017.02.015 Looking for a needle in a haystack – Breast sonography Elizabeth Phillips 1 1 BreastScreen Australia Breast sonography can feel like navigating the wilderness or searching for a needle in a haystack. It plays a vital role in detecting subtle abnormalities, guiding biopsies and ultimately contributing to a definitive diagnosis. Breast ultrasound uses soundwaves to create detailed images of breast tissue and is commonly used to investigate a range of symptoms, including the detection and characterisation of breast lumps. It is particularly valuable in distinguishing solid masses from fluid‐filled cysts and in assessing nipple discharge or other structural changes. As a safe, painless and non‐invasive technique, breast ultrasound often complements mammography to provide a more complete diagnostic picture. Delivering high‐quality breast sonography, however, relies on several key factors. This presentation will explore these essential elements, along with practical tips and techniques to help sonographers improve detection – whether it's finding the proverbial needle in a haystack or identifying a 3 mm invasive ductal carcinoma. Saturday 28 March, 2:00 PM – 3:30 PM Listening to Survivors Life after: From survivor to thriver Sally Ball 1 1 Princess Alexandra Hospital, Brisbane, Australia This author's life was changed forever when she sat in her GP's office and listened to the words, “You have breast cancer”. She was 40 years old and had been performing mammograms since the start of her career when she herself was diagnosed with breast cancer. While being a patient was challenging, the harder part came in learning to adapt to life after cancer. Survivorship. After years of working with breast cancer patients, one of the biggest surprises for the author was that when you are going through cancer, no‐one talks to you about life after. The survivor dealing with changes to their body. The survivor dealing with the effects of hormone treatment. The survivor dealing with scanxiety and the fear of recurrence. For the author, one of the biggest challenges was returning to work and dealing with patients who faced the same disease with varying levels of prognosis. This presentation covers the journey from survivor to thriver; how the author needed to adapt to a new normal and discover a new life after breast cancer. A life that included more compassionate patient care, returning to the modality she loved, and taking up a new hobby that engages many breast cancer survivors around the world: dragon boating. Breaking bad news in cancer care: What patients teach us about communication and empathy Shayne Chau 1 1 Charles Sturt University, Wagga Wagga, Australia Introduction: Communication during the disclosure of life‐altering diagnoses represents one of the most emotionally charged moments in cancer care. Understanding how patients experience these interactions is essential to improving patient‐centred communication across the multi‐disciplinary team. 1 Objective: To explore patient experiences of communication with cancer multi‐disciplinary healthcare professionals during the process of ‘breaking bad news’. Methods: A qualitative systematic review was conducted following the Joanna Briggs Institute methodology for qualitative evidence synthesis and reported according to PRISMA guidelines. APA PsycINFO, CINAHL, Medline, and Scopus were searched from inception to April 2023. Studies were included if they reported qualitative data on patient experiences of clinician communication during the disclosure of a cancer diagnosis. Data extraction and quality appraisal were performed independently by reviewers, and meta‐aggregation was used for synthesis. Results: 28 studies met inclusion criteria, encompassing 976 patients across diverse cancer types and healthcare settings. Seven synthesised findings were generated: sensing something is wrong prior to diagnosis, emotional reactions to the diagnosis, information exchange during disclosure, communication style and empathy, differences between specialist and non‐specialist centres, involvement in decision‐making, and feeling supported after disclosure. Patients valued honesty, empathy and pacing of information, and reported distress when communication was rushed or impersonal. Conclusions: Breaking bad news in oncology requires personalised, empathetic and culturally responsive communication. Education and training across cancer multi‐disciplinary teams should prioritise relational competence and adaptive communication strategies to meet individual patient needs, particularly within increasingly digital modes of clinical interaction. Reference 1. Primeau C, Chau M, Turner MR, Paterson C. Patient experiences of patient–clinician communication among cancer multidisciplinary healthcare professionals during “breaking bad news”: a qualitative systematic review. Semin Oncol Nursing 2024;40(4):151680. Person‐centred cancer survivorship through patient‐initiated follow‐up: Qualitative insights from the evidence Shayne Chau 1 , Catherine Paterson 2,3 , Murray Turner 4 , Charlotte Primeau 5 1 Charles Sturt University, Wagga Wagga, Australia, 2 Flinders University, Adelaide, Australia, 3 Central Adelaide Local Health Network, Adelaide, Australia, 4 University of Canberra, Bruce, Australia, 5 University of Warwick, Coventry, United Kingdom Introduction: Patient‐initiated follow‐up (PIFU) models shift responsibility from clinicians to patients, aiming to enhance autonomy and reduce unnecessary hospital visits. Evidence on how PIFU is experienced in practice remains limited. This review synthesised qualitative evidence on the lived experiences and preferences of people affected by cancer, their families and healthcare professionals engaged in PIFU. Methods: A qualitative systematic review was undertaken using the Joanna Briggs Institute (JBI) meta‐aggregation approach. Six databases were searched in July 2025. Studies were included if they reported qualitative data on experiences of PIFU following cancer treatment. Data extraction, critical appraisal, and synthesis followed JBI guidance. The review adhered to PRISMA reporting standards and was registered with PROSPERO (CRD420251103470). Results: Eight studies, all conducted in the United Kingdom, were included (120 cancer survivors, 63 healthcare professionals and three family members). Four synthesised findings emerged: 1) PIFU empowers patients but requires risk‐based and personalised implementation; 2) PIFU promotes self‐management yet disparities in education, communication and support persist; 3) patients value PIFU for convenience, cost‐efficiency and emotional relief; and 4) some individuals continue to seek face‐to‐face reassurance. Conclusion: PIFU can provide an effective, person‐centred model of cancer survivorship care when aligned with patients’ psychosocial readiness and support needs. Implementation should include structured education on symptom recognition, rapid access pathways and assessment of self‐management capability to ensure equitable and safe follow‐up. Saturday 28 March, 2:00 PM – 3:30 PM Navigating Image Evaluation (MI) Navigating the economic rationale for implementing a radiographer comment and alert model in emergency departments Ingrid Klobasa 1 , Dennis Petrie 2 , Marilyn Baird 1 , Jenny Sim 1 1 Department of Medical Imaging and Radiation Science, Monash University, Melbourne, Australia, 2 Centre for Health Economics Monash Business School, Monash University, Melbourne, Australia Introduction: The 2024–25 NSW Health Budget allocated $35 billion, including $500 million for easing emergency department (ED) pressures. 1 To help reduce avoidable costs, innovations like the Radiographer Comment and Alert (RCA) Model of Care warrant cost effectiveness evaluation. Methods: Current general imaging costs were compared with costs and potential savings generated through multi‐site RCA implementation. Cost effectiveness analysis was based on a 200‐bed (rural) hospital assuming 35% daily average abnormality rate. Results: The average cost per radiographer comment was $23.00, which includes the estimated cost of harm ($1.08 per case). Early identification of clinically significant findings was associated with a potential reduction of at least 1 hour in ED length of stay. National pricing for this ED time is $176/hour for minor‑complexity cases, $500/hour for medium‑complexity cases, and $800/hour for high‑complexity cases. 2 The cost of implementing the multi‑site RCA MoC (n = 1100 cases) was approximately $25,000. 2 282 clinically significant RCA cases were recorded by auditors (omitting extremity fractures). Assuming these comprised 50% minor, 40% medium and 10% high complexity presentations, $103,000 savings could be identified if these patients avoided an additional hour in ED. This would result in a net saving of $78,000 per 1100 RCAs. Conclusion: The RCA MoC offers a cost‐effective solution that can reduce the cost of patient delays in ED, avoid the cost of diagnostic errors, and expediate time to treatment. With minimal added medical imaging costs, this model could save hospitals hundreds of thousands annually, delivering high‐impact reform with a low‐cost lift. References 1. Park R. 2024‐25‐NSW Budget. A plan to build a better health system for NSW communities. Sydney: NSW Government 2024;1–3. 2. Independent Health and Aged Care Pricing Authority. 2022. Pricing framework for Australian public hospital services 2023‐24. Radiographer initiated X‐rays: A pilot study on professional scope expansion in the emergency department Serenity Meredith 1,2 , Ashlyn Mc Burnie 1 , Iulio Tavete 1 , Christopher Edwards 1,2 1 Redcliffe Hospital, Redcliffe, Australia, 2 Queensland University of Technology, Brisbane, Australia Introduction: Medical imaging is integral to emergency department (ED) workflows, with musculoskeletal injuries frequently requiring timely radiographic assessment. While nurse and physiotherapist‐initiated X‐ray protocols are increasingly adopted, radiographer‐led imaging decisions remain underexplored. This pilot study investigates the potential for radiographers to independently identify appropriate imaging for musculoskeletal extremity injuries in an ED setting. Methods: Using a retrospective review of ED triage data from March 2022 to March 2023, of 5769 musculoskeletal presentations, 90 clinical scenarios were selected and presented via an online survey to radiographers, nurse practitioners and ED consultants. Participants selected the most suitable anatomical region for imaging, and inter‐rater reliability was evaluated using Fleiss’ Kappa. Results: Results demonstrated high agreement across all groups FK = 0.948 (95% CI: 0.943–0.953), with radiographers showing particularly strong internal consistency and alignment with ED consultants. These findings suggest radiographers are well‐positioned to contribute to imaging decision‐making, supporting future development of radiographer‐initiated X‐ray (RIX) protocols to enhance ED efficiency and patient care. Conclusion: Radiographers demonstrated strong agreement with ED consultants in X‐ray request decision making. These findings support extended scope of practice and the development of RIX competencies in the ED. Leading through resistance: What we learn when we listen, adapt and discover Michael Neep 1 1 Queensland University of Technology, Brisbane, Australia Change is a constant in the medical radiation professions, yet its implementation is often complex and fraught with challenges. When poorly executed, change initiatives can negatively impact staff morale and retention, compromise patient care and place pressure on budget targets. 1 To mitigate these risks, a structured and systematic change process is essential – one that supports the transformation of departmental goals, workflows and technologies. Change management aims to implement strategies that guide, support and empower people through transition. While numerous change management models exist, their application within the nuanced and often unpredictable landscape of health care remains uncertain. 2 This presentation introduces a practical, four‐step framework for effective change management in medical radiation settings. Using the implementation of radiographer preliminary image evaluation as a real‐world case study, 3 this presentation will explore the key elements of success, including effective communication planning, stakeholder engagement and monitoring and evaluation, while also identifying common pitfalls. Given the time, cost, and human resources invested in change initiatives, and the potentially significant consequences of failure, it is critical that healthcare organisations adopt evidence‐informed and systematic approaches to change. By listening to staff concerns, adapting strategies to fit local contexts, and discovering what works through continuous evaluation, change can be championed successfully. References 1. Cummings GG, Tate K, Lee S, et al. Leadership styles and outcome patterns for the nursing workforce and work environment: a systematic review. Int J Nurs Stud 20181;85:19–60. 2. Kotter JP. Leading change. Boston: Harvard Business Review Press; 2012. 3. Brown C, Neep MJ, Pozzias E, McPhail SM. Reducing risk in the emergency department: a 12‐month prospective longitudinal study of radiographer preliminary image evaluations. J Med Radiat Sci 2019;66(3):154–62. Navigating readiness: Exploring radiographers’ perspectives on Preliminary Image Evaluation in Ghana Bismark Ofori‐Manteaw 1,2 , George Omari 2 , Seth Angmorterh 2 , Eric Ofori 3 , Klenam Dzefi‐Tettey 4 1 Charles Sturt University, Wagga Wagga, Australia, 2 Department of Medical Imaging, University of Health and Allied Sciences, Ho, Ghana, 3 University of Cape Coast, Cape Coast, Ghana, 4 Department of Radiology, University of Health and Allied Sciences, Ho, Ghana Introduction: Preliminary Image Evaluation (PIE) offers opportunities for radiographers to contribute to timely diagnostic decision‐making, particularly in resource‐limited settings. 1‐3 This study examined radiographers’ readiness for PIE by assessing their interest, willingness and confidence, and identifying perceived barriers, enablers and benefits. Methods: A quantitative cross‐sectional survey of diagnostic radiographers in Ghana was conducted. Data on psychological readiness, systemic factors and current practice were collected and analysed using SPSS v24. Results: 195 radiographers responded to the survey. Radiographers demonstrated high interest, willingness and confidence in PIE, with 100% agreeing or strongly agreeing that PIE should form part of their role. 93.8% of radiographers reported confidence in commenting on trauma‐related findings, while 94.9% expressed confidence in identifying abnormalities on routine X‐ray images. All the participants (100%) were willing to undergo further training and participate in formal PIE programs. Key barriers included medicolegal concerns (n = 193, 98.9%), absence of structured training (n = 182, 93.3%) and lack of policy guidelines (n = 117, 60%). Enablers included supportive policy frameworks (n = 194, 99.5%) and radiologist shortages (n = 183, 93.8%). PIE was perceived to improve clinical decision‐making (n = 194, 99.5%), enhance service delivery (n = 188, 96.4%), and expand diagnostic access in underserved regions (n = 175, 89.7%). Most radiographers (86.7%) had informal exposure to PIE and preferred formalised, blended training. Conclusion: Radiographers in Ghana demonstrate strong readiness for PIE. Establishing structured training and policy frameworks are essential to support role extension, enhance professional growth and improve patient‐centred diagnostic care. References 1. Hazell L, Motto J, Chipeya L. The influence of image interpretation training on the accuracy of abnormality detection and written comments on musculoskeletal radiographs by South African radiographers. J Med Imaging Radiat Sci 2015;46(3):302–8. https://doi.org/10.1016/j.jmir.2015.03.002 2. Ofori‐Manteaw BB, Dzidzornu E. Accuracy of appendicular radiographic image interpretation by radiographers and junior doctors in Ghana: can this be improved by training? Radiograph 2019;25(3):255–9. https://doi.org/10.1016/j.radi.2019.04.003 3. Anudjo M, Docherty S, Akudjedu T. Preliminary clinical evaluation (PCE): a transnational scoping review of current radiography practice. J Med Imaging Radiat Sci 2025;56(2). https://doi.org/10.1016/j.jmir.2024.101815 Through the wilderness – Charting the implementation of a Preliminary Image Evaluation program Ryan Shaw 1,2 1 Western Health, Melbourne, Australia, 2 Deakin University, Geelong, Australia Introduction: Following baseline assessments in 2024, a radiographer‐led Preliminary Image Evaluation (PIE) program was implemented to enhance accuracy in pathology recognition and escalation. This presentation outlines the first year of implementation, highlighting the early steps of navigating new terrain through targeted education, audit outcomes and steady program growth. Method: The implementation of the PIE program commenced in January 2025, incorporating monthly education modules covering key anatomical regions. Sessions, designed and delivered by radiographers (Grade 1–4), included lectures, quizzes and ‘cheat sheets’, with CPD certification offered for participation. All PIE comments were audited by a two‐radiographer team to ensure protocol compliance and accuracy. Monthly departmental feedback, performance awards and targeted modules addressed recurrent errors. Results: Since implementation, more than 2000 PIE comments have been completed, with accuracy improving from 64% initially to 95%. Monthly commenting volume increased from 140 to 350+, with participation averaging 58–72 radiographers. Anecdotally, radiographers reported increased confidence in image critique and interpretation, particularly junior staff, that demonstrated strong engagement despite initial scepticism from few senior colleagues. Auditing revealed the importance of continual feedback loops to adapt education and clarify protocols. Conclusion: The first year of PIE implementation demonstrates that radiographer‐led commenting can be embedded into daily workflow with improved accuracy, participation and confidence. Sustaining this growth will involve expanding into other modalities, measuring clinical impact and preparing for electronic medical record integration – charting the path toward more timely diagnoses and improved patient outcomes. More than a comment: Radiographers’ perspectives on image interpretation and image quality Allie Tonks 1 , Johnathan Hewis 2 , Yobelli Jimenez 1 , Frances Gray 1 , Ernest Ekpo 1 1 The University of Sydney, Sydney, Australia, 2 Charles Sturt University, Wagga Wagga, Australia Introduction: Radiographic image quality comprises three main determinants: choice of technique, appropriate dose, and diagnostic utility. While the focus for radiographers is often on technical and dosimetry parameters, radiologists prioritise diagnostic utility. It has been suggested that radiographer participation in image interpretation may improve their understanding and delivery of X‐ray image quality; however, this has not been directly examined. Therefore, the aim of this study was to investigate radiographers’ perspectives on X‐ray image quality following implementation of radiographer commenting. Methods: Radiographers who worked at hospitals that had implemented a Radiographer Comment and Alert model were invited to participate in small online focus groups. Qualitative data from 13 participants was analysed using Braun & Clarke's reflexive thematic analysis to generate themes and subthemes relevant to the study aim. Results: Six main themes were identified. The overarching finding was that image interpretation improved understanding and delivery of X‐ray quality. The remaining five themes recognised mechanisms contributing to this: increased thought and reflection on imaging, enhanced performance expectations radiographers sought to meet, deeper knowledge‐building and learning practices, improved technical decision making and increased collaboration. Conclusion: Introduction of formal image interpretation practices can be used as a tool to improve radiographers’ understanding and production of high‐quality X‐rays, which provide clinical and economic healthcare benefits. Saturday 28 March, 2:00 PM – 3:30 PM Discovering Therapy Innovations (RT) A look at the what, when and why of spatially fractionated radiotherapy Mark Burns 1 1 Peter MacCallum Cancer Centre, Melbourne, Australia Spatially fractionated radiotherapy (SFRT) refers to the novel and non‐conventional technique which aims to treat large and radioresistant tumours more effectively. Studies have shown promising results when delivering ablative doses to part of the tumour in alleviating symptoms and reducing the size of tumours, with low toxicity. 1 SFRT techniques and modalities are varied, photons and protons can be used to deliver lattice, GRID 2 and simultaneous integrated boost dosimetry to tumours. 3 Our own institutional technique of partially ablative body radiotherapy is such a technique. Even more novel approaches are being investigated using FLASH (ultra‐high dose rate) delivery, micro‐beam (synchrotron generated) and mini‐beam (orthovoltage and linear accelerator delivered) approaches. Investigations are underway into the biological mechanisms behind its effectiveness, particularly the potential bystander and abscopal effect of radiation treatment. Variations in spacing between high‐dose areas, methods of delivery, fractionation and total dose also continue to be analysed. The peak dose, valleys of low dose and the spacing between these areas is an active area of research. Variation between studies in low dose tumour coverage also exists, with some delivering base level palliative doses and others not. This presentation will outline the relevant literature to date and put the status of SFRT into context for local practice. It will explore current developments, including ongoing work at a major Australian cancer centre, and potential future directions in this field. References 1. Iori F, Cappelli A, D’Angelo E, et al. Lattice radiation therapy in clinical practice: a systematic review. Clin Transl Radiat Oncol 2023;39:100569. 2. Ferini G, Parisi S, Lillo S, et al. Impressive results after "metabolism‐guided" lattice irradiation in patients submitted to palliative radiation therapy: preliminary results of LATTICE_01 multicenter study. Cancers 2022;14. 3. Liveringhouse CI, Palm RF, Bryant JM, et al. Neoadjuvant simultaneous integrated boost radiation therapy improves clinical outcomes for retroperitoneal sarcoma. Int J Radiat Oncol Biol Phys 2023;117:123–38. From learning to leading: Building local proton planning capability Rosanna Crain 1,2 1 Australian Bragg Centre for Proton Therapy & Research, Adelaide, Australia, 2 Royal Adelaide Hospital, Adelaide, Australia Developing local expertise in proton planning is essential as Australia prepares to introduce proton therapy. While several universities now offer proton therapy modules, no postgraduate or advanced practice training pathways currently exist for proton therapy planning in Australia. Aligning with the peak body position statement that a comprehensive in‐house training program should span localisation, simulation, planning, quality assurance and delivery, 1 a dedicated induction and credentialling program was established within a national proton therapy service. The centre serves as the national hub for comparative proton planning and currently manages over 150 referrals, with 120 cases available for training. These include a wide range of diagnoses, providing planners with exposure to varied clinical presentations. Training plans are benchmarked against clinically acceptable dosimetry, enabling structured evaluation of performance. The program combines modular learning with supervised case‐based training, progressing from simple to complex scenarios. Credentialling is achieved through demonstration of competence against defined clinical standards, ensuring consistency and safety. Importantly, the program is designed to be sustainable and adaptable, supporting the onboarding of future staff as clinical services expand. By developing an in‐house credentialling pathway, this initiative future‐proofs the workforce, reduces reliance on overseas training and builds national capacity in proton planning. This presentation will outline the program's development, implementation and early outcomes, offering insights into how structured training supports workforce readiness for the introduction of proton therapy in Australia. Reference 1. Australian Society of Medical Imaging and Radiation Therapy. 2025. Minimum requirements to work in proton beam therapy in Australia [Internet]. Available at https://asmirt.org/wp‐content/uploads/2025/05/ASMIRT‐Min‐requirements‐PBT_May‐2025.pdf Digital workshop: Driving innovation in personalised radiation therapy with 3D printing Gordon Lu 1 1 Princess Alexandra Hospital, Brisbane, Australia In the evolving field of radiation therapy, innovation and adaptability are key to delivering precise, patient‐centred care. Integration of technological advancements from other fields can facilitate novel approaches to existing challenges. This is where the concept of the ‘digital workshop’ was born. The digital workshop integrates clinical expertise, CAD design and 3D printing technology to create customised treatment devices. This initiative bridges the gap between clinical needs and commercially available solutions, enabling rapid, in‐house production of patient‐specific tools. The vast majority of devices produced are for daily clinical use, enhancing workflow efficiency and treatment accuracy. The remainder involve bespoke adaptive designs – unique immobilisation aids, shielding components and beam‐modifying accessories, tailored to complex patient presentations and unconventional treatment setups. Each device is developed through a creative, problem‐solving approach informed by direct patient interaction and practical treatment experience. The digital workshop not only fosters innovation but also empowers radiation therapists to take ownership of the design process, driving quality improvement and enhancing patient comfort. This presentation will describe the establishment and operation of the digital workshop and provide examples of novel devices that have been created. By combining technology and clinical insight, the digital workshop showcases how frontline professionals can ‘think outside the box’ to transform routine practice and push the boundaries of personalised radiotherapy. Biology‐guided treatment delivery system: A single institution experience Daniel Pham 1 1 Stanford Medicine, Palo Alto, California, United States Biology‐guided radiotherapy (BgRT) is based on real‐time detection of tumour biophysics to deliver radiation to the tumour accurately. In this world‐first system integrating a PET/CT with a linac, two imaging modes are available for treatment: IMRT/IGRT mode to deliver IMRT plans using kVCT imaging for target localisation; and BgRT mode for stereotactic ablative body radiotherapy treatment of lung and bone tumours using functional imaging for target tracking and treatment. In 2020, our institution was the first to commission and go live with the PET‐linac system. To date, our institution has safely treated over 300 patients using standard IMRT delivery and modelled over 12 patients using BgRT. In this presentation, attendees will: learn about the principles of BgRT learn about the clinical implementation of a BgRT workflow within an institution learn about the advantages/limitations of BgRT treatment see comparisons of traditional volumetric modulated arc therapy plans against a novel treatment planning system. Navigating the technological wilderness: Lessons learned from an academic institution Daniel Pham 1 1 Stanford Medicine, Palo Alto, California, United States The global cancer burden is on the rise, with a projected number of new cases to be over 21 million in 2050, with an estimated radiotherapy utilisation rate of over 55% in high‐income countries. Based on this global trend, advances in technology can help manage cancer care, with improvements focussed on areas such as treatment workflow, dose delivery and tumour localisation. Despite the abundance of new technology and workflows, there is a clinical burden in supporting and implementing new practices. Over the past 5 years, our department has implemented new systems, including volumetric modulated arc therapy autoplanning, volumetric modulated arc therapy total‐body treatment, automated chart checks, biology‐guided treatment, adaptive workflows and, more recently, upright proton treatment. In this presentation, we will discuss the challenges and successful strategies we used as we navigated the technological wilderness. Saturday 28 March, 2:00 PM – 3:30 PM Innovating Healthcare Education Beyond inclusivity: Applying inherent requirements to feed medical radiation science students forward Jacob Leonard Ago 1 , Andrew Kilgour 1 , Clare Smith 1 , Natalie Pollard 2 1 RMIT University, Melbourne, Australia, 2 Queensland University of Technology, Brisbane, Australia Introduction: Medical radiation science is a high‐pressure profession due to increased workload, technological advancements and fast patient turnaround time. 1 Although prospective students have the desire to contribute to patient care, they may be unaware of these stressors, potentially leading to: 1) wrong career choices; 2) their unpreparedness in managing challenging clinical interactions (CCIs); and 3) dissatisfaction with clinical placements. All these factors contribute to student attrition. 2 Inherent requirements (IRs) have been identified as essential tools to enhance coping and resilience. 3 This study examines practical strategies through which IRs can prepare students for stressors of clinical placements. Methods: This was a qualitative descriptive study involving seven purposively sampled Australian medical radiation science academics. Semi‐structured interviews were conducted via Microsoft Teams. The data were transcribed verbatim, checked for correctness and analysed through reflexive thematic analysis. Results: IRs were identified as essential tools to prepare students for unexpected CCIs. Strategies to implement this feedforward function include: 1) creating early awareness of professional demands; 2) preparing students for CCIs; 3) proactively recognising and supporting student needs; and 4) promoting reflective insight and self‐evaluation. To sustain these feedforward strategies requires: 1) strategic communication and repackaging IRs; 2) IRs to be embedded into curricula as feedforward tools; and 3) stakeholder engagement to promote shared understanding of the essential role of IRs beyond inclusivity. Conclusion: Applying IRs as feedforward strategies can help medical radiation sciences to discover and adapt their abilities to navigate the wilderness (i.e. CCIs) of MRS clinical education, thereby facilitating their professional identity formation and resilience. References 1. Thomas H, Naidoo K, Engel‐Hills P. Resilience from the perspective of diagnostic radiography students. Radiography 2023;29(1):56–61. https://doi.org/10.1016/j.radi.2022.10.001 2. McAnulla SJ, Ball SE, Knapp KM. Understanding student radiographer attrition: Risk factors and strategies. Radiography 2020;26(3):198–204. https://doi.org/10.1016/j.radi.2019.12.001 3. Ago JL, Kilgour A, Smith CL, Pollard N. Applying inherent requirements to foster resilience, fitness to practice, and inclusivity in medical radiation science education: a qualitative study. Radiography 2025;31(6). https://doi.org/10.1016/j.radi.2025.103145 Navigating workforce‐ready radiographers: Bridging education and practice through capstone activities Therese Gunn 1 , Cameron Moore 1 , Deborah Starkey 1 , Ajesh Singh 1 , Vicki Braithwaite 1 , Noirin Neligan 1 , Pamela Rowntree 1 1 Queensland University of Technology, Brisbane, Australia In a landscape of evolving technologies, complex healthcare systems and shifting patient needs, educational institutions need to ensure diagnostic radiography students are work ready at graduation. Lawton et al used the Work Readiness Score to evaluate allied health graduates’ perceived work readiness identifying four main factors: interpersonal capabilities, practical wisdom, personal attributes and organisational acumen. 1 This presentation explores a fourth‐year undergraduate capstone program designed to align with the Medical Radiation Practice Board of Australia (MRPBA) Professional Capabilities for Medical Radiation Practitioners, which define the essential knowledge, skills and attributes for safe and competent practice. 2 This can then align with the work of Zhang et al on their evaluation of the initial experiences of new radiography graduates in the clinical workforce. 3 As an example, students from an Australian university navigate their final year through diverse, practice‐based projects. These include completion of clinical placement competencies; evidencing safe practice and clinical reasoning through reflective portfolios mapping activities to MRPBA domains, peer mentoring, and research projects culminating in seminar presentations and article writing. Each activity encourages students to listen to feedback, adapt to challenges and discover their professional identity. This model offers a responsive and scalable framework for embedding professional capabilities into radiography education – ensuring graduates are not only academically prepared but also professionally equipped to enter the workforce as safe, competent and confident diagnostic radiographers. In effect, crossing the MRPBA Threshold professional capability from student to practitioner. 2 Future work to evaluate new graduate perceptions is essential to align with literature in other allied health disciplines. References 1. Lawton V, Ilhan E, Pacey V, et al. A work readiness scale for allied health graduates. Internet J Allied Health Sci Pract 2023;22(1):16. 2. Medical Radiation Practice Board of Australia. 2020. Professional capabilities for medical radiation practitioners. Available at https://www.medicalradiationpracticeboard.gov.au/Registration‐Standards/Professional‐Capabilities.aspx 3. Zhang J, Makanjee C, Hayre CM, Lewis S. Australian graduate radiographers’ perspectives and experiences of work readiness. J Med Radiat Sci 2023;70(3):254–61. https://doi.org/10.1002/jmrs.675 Trans‐Tasman radiation therapy student peer‐group supervision: A pilot study Angelina Piccolo 1 , Gay Dungey 2 , Kristie Matthews 1 , Caroline Wright 1 1 Monash University, Melbourne, Australia, 2 University of Otago, Wellington, New Zealand Introduction: Peer group supervision (PGS) is where small groups of healthcare practitioners intentionally gather to ‘focus on developing interpersonal skills to manage challenging clinical situations, workplace stress, emotional and ethical dilemmas’. 1 While previous studies have highlighted the benefits of PGS for professionalism, wellbeing and reflective practice, 1,2 PGS sessions primarily occur face‐to‐face, within or near the workplace. Studies of PGS with health practitioner students are limited. This project aimed to examine the feasibility of implementing online PGS with final‐year radiation therapy students from Australia and New Zealand, as well as the students' experiences of using this approach. Methods: 10 students completing clinical placement, consented to participate in the ethics‐approved study. Students completed online introductory training and then participated in monthly 1‐hour online PGS sessions over 4 months within Trans‐Tasman cohorts. Online sessions were peer‐facilitated and guided by structured reflective frameworks. Pre‐ and post‐intervention surveys captured both quantitative and qualitative data on student expectations, engagement and outcomes. Results: An 80% survey response rate was achieved. Students valued PGS attendance and reported that online PGS provided a safe, collegial space that fostered emotional support, professional confidence and reflective learning. Cross‐institutional engagement enhanced camaraderie and broadened perspectives on clinical practice. Conclusion: This pilot study demonstrates that online PGS is a feasible and effective model for supporting radiation therapy students’ wellbeing and professional development across geographic boundaries. Broader implementation within health professional education may further enhance student resilience, engagement and collaborative practice. Future research should investigate long‐term outcomes and scalability across disciplines. References 1. Dungey G, Neser H, Sim D. New Zealand radiation therapists’ perceptions of peer group supervision as a tool to reduce burnout symptoms in the clinical setting. J Med Radiat Sci 2020;67:225–32. 2. McCarthy V, Goodwin J, Saab M, et al. Nurses and midwives’ experiences with peer‐group clinical supervision intervention: a pilot study. Journal of Nursing Management 2021;29(8):2523–33. Supporting neurodivergent students in healthcare education: Lessons from SSHINE Ben Potts 1,2 1 City St George's, University of London, London, United Kingdom, 2 University Hospital Southampton, Southampton, United Kingdom Neurodivergent (e.g. autistic, ADHD, dyslexic, dyspraxic) healthcare students often face barriers that affect their confidence, progression and sense of belonging. Many describe having to mask their difficulties for fear of stigma and having their competence called into question. These challenges are most pronounced during clinical placements, where awareness of neurodivergent needs is often low and inclusive educational practices are inconsistently applied. As a result, students can struggle to access the adjustments they require, thereby not reaching their potential or, in some cases, leaving courses entirely. A multi‐professional group of students co‐founded SSHINE (Staff & Student Healthcare Initiative for Neurodiversity & Equity) to address these issues. SSHINE became a nationally recognised contributor to inclusive education policy and practice. It has co‐produced two key resources: the NHS England Practice‐Based Learning Guide for Neurodivergent Students and an e‐learning module for practice educators, developed with the Florence Nightingale Foundation. Both offer clear, practical and evidence‐based strategies for supporting learners. Centred on the lived experience of a neurodivergent radiographer, this presentation will explore the support students may need, share practical lessons from SSHINE's resources, and reflect on the group's continuing work. It argues that meaningful inclusion requires a systemic shift in culture, expectations and educational practice. True progress begins when we stop treating neurodivergence as a limitation and start recognising it as a professional strength. The inclusion of a diverse workforce, enriched by a wide range of ways of thinking, ultimately benefits not only the profession but also the patients and communities it serves. Integrating consumer co‐design into interprofessional collaborative learning about breast cancer: Exploring student and consumer experiences Caroline Wright 1 , Debra Kiegaldie 1 1 Monash University, Melbourne, Australia Introduction: Interprofessional collaborative practice is an integral part of ensuring high quality person‐centred health care, 1 and is therefore a necessary component of health professions education. 2 Consumer voices in education provide a powerful narrative that grounds theoretical knowledge in real‐world experience, highlighting the importance of empathy, communication and collaborative teamwork. 3 The principles of interprofessional practice and consumer co‐delivery were combined to create a workshop focussed on breast cancer for health professions students. The aim of this mixed methods evaluation was to explore student and consumer experiences of the workshop. Methods: 485 students (medical, radiography, social work, radiation therapy, radiation science) participated in a 2‐hour workshop, focussing on the impact of interprofessional collaboration on breast cancer survivor (consumer) lived experiences. Workshops were delivered by an interprofessional team of academics, clinicians and consumers, on campus and online. Breast cancer survivors were recruited through cancer survivor consumer groups. Workshop design, implementation and outcomes were evaluated through a voluntary student survey delivered at the end of the workshop. Three breast cancer survivors participated in individual interviews conducted via zoom. Descriptive statistics were used to analyse the survey and thematic analysis was used to analyse the consumer experiences. Results: Preliminary evaluation suggests that the consumer lived experience narratives enriched the learning experience, promoting deeper understanding of interprofessional roles and collaborative practice. Conclusion: The results of the evaluation offer insights into the value of consumer co‐delivery through narratives of lived experience during interprofessional collaborative practice education, shaping future‐ready, compassionate, collaborative healthcare professionals. References 1. Anderson E, Smith R, Hammick M. Evaluating an interprofessional education curriculum: a theory‐informed approach. Med Teach 2015;38(4):385–94. https://doi.org/10.3109/0142159X.2015.1047756 2. Maddock B, Dārziņš P, Kent F. Realist review of interprofessional education for health care students: What works for whom and why. J Interprof Care 2023;37(2):173–86. 3. Fossey E, Bonnamy J, Dart J, et al. What does consumer and community involvement in health‐related education look like? A mixed methods study. Adv Health Sci Educ 2024;29:1199–218. https://doi.org/10.1007/s10459‐023‐10301‐3 Saturday 28 March, 2:00 PM – 3:30 PM Patient Centred Discovery (RT) Exploring the experiences of women with breast cancer in the radiotherapy department in Ghana Vivian Della Atuwo‐Ampoh 1 , Margaret Gyapong 1 , Penelope Engel‐Hills 2 , Eric Kwasi Ofori 1 , Mary Boadu 3 , Andrew Donkor 4 , Klenam Tetteh 1 , Patience Addo 1 , Joel Kwadjo Yarney 5 , Elizabeth Davis 6 1 University of Health and Allied Sciences, Ho, Ghana, 2 Cape Peninsula University of Technology, Cape Town, South Africa, 3 Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, Accra, Ghana, 4 Kwame Nkrumah University of Sciences and Technology, Kumasi, Ghana, 5 National Radiotherapy and Nuclear Medicine, Korle‐bu Teaching Hospital, Accra, Ghana, 6 Cancer Epidemiology and Research, King's College London, London, United Kingdom Introduction: Breast cancer is a commonly diagnosed malignancy in women. 1 The increasing burden of breast cancer in low‐ and middle‐income countries is established. 2 Delays in diagnosis and treatment persist, influenced by obstacles. In Ghana, cases are reported at advanced stages, resulting in poor outcomes. There are limited resources to tackle the burden of breast cancer in Africa. Women with breast cancer have different experiences, and hence the need to explore. Objective: To explore the experiences of patients with breast cancer and identify barriers to care in the radiotherapy department. Method: The study adopted an exploratory‐descriptive qualitative design. Using a series of semi‐structured interviews to develop an in‐depth understanding of breast cancer management from the experiences of patients. Participants were assured of their privacy. Results: 12 patients (age range 35–70 years) with breast cancer were recruited (Fig. 1). Interviews were recorded and transcribed. NVivo‐12 was used for analyses. Most of the women were married (n = 8). Stage III cancer was common (n = 6). Three themes and eight sub‐themes were identified: 1) the breast cancer diagnostic journey; 2) patient perspective of effective care; and 3) improving patient experiences. Nearly all the women reported detecting a lump as initial finding, consistent with many previous reports. 3 Conclusion: This study explored women's experiences of receiving care within the radiotherapy department. It highlighted processes required to improve initial diagnosis and barriers women perceive as hindering care. It also provided new insight into ways to improve the care experiences of women and the need for a supportive care network. References 1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68(6):394–424. https://doi.org/10.3322/caac.21492 2. Deressa BT, Cihoric N, Badra EV, et al. Breast cancer care in northern Ethiopia ‐ cross‐sectional analysis. BMC Cancer 2019;19(1):393. https://doi.org/10.1186/s12885‐019‐5612‐6 3. Ferlay J, Colombet M, Soerjomataram I, et al. Cancer statistics for the year 2020: an overview. International Journal of Cancer 2021;149(4):778–89. https://doi.org/10.1002/ijc.33588 A SOFT approach: Staff perspectives on implementing SimulatiOn Free radiation Therapy for simple palliative treatments Felicity Hudson 1,2,3 , Kylie Dundas 1,2,3 , Cesar Ochoa 1 , Phil Vial 1 , Daniela Miller 1 , Alison Gray 1,2,3 , Carol‐Lan Wilder 1 , Michael Cardoso 1,2 , Michelle Roach 1 , Andrew Wallis 1 , Shalini Vinod 1,2,4 1 Liverpool and Macarthur Cancer Therapy Centres, Liverpool, Australia, 2 The University of New South Wales, Sydney, Australia, 3 Ingham Institute for Applied Medical Research, Liverpool, Australia, 4 Collaboration for Cancer Outcomes Research and Evaluation, Ingham Institute for Applied Medical Research, Liverpool, Australia Introduction: Palliative radiotherapy is an important treatment to reduce cancer symptoms. 1 Barriers to accessing timely radiotherapy include both patient and service issues. 2 Implementation of SimulatiOn Free radiation Therapy (SOFT) workflows using diagnostic CT scans improves access and reduces burden to patients and families. 3 Methods: After education sessions, SOFT was implemented in March 2025. Implementation included a staff questionnaire with mixed Likert and free‐text responses, to determine staff acceptability and workflow impacts. Radiation oncologists, radiation therapists and medical physicists responded after each SOFT workflow involvement, up to two times. Summative content analysis identified themes from free‐text responses. Results: Between March and September 2025, 39 patients underwent 45 SOFT workflows, with 40 proceeding to treatment (88.9%). 58 surveys were completed (seven radiation oncologists; nine medical physicists; 42 radiation therapist‐planning/treatment). 81% of respondents felt the SOFT workflow was acceptable/slightly acceptable compared to traditional simulation. 81% of staff agreed/somewhat agreed that SOFT was a viable alternative to traditional workflows. Qualitative and quantitative measures indicated a perceived increase in work time, primarily by radiation therapists. Initial evaluation showed duration of first treatment increased (31.1 ± 11.6 min SOFT; 25.7 ± 14.3 min traditional); this was offset by the removal of the simulation appointment (20.1 ± 4.9 min). Free‐text responses highlighted pain management and appointment length issues for first treatment, leading to the development of a nurse‐led pain management review prior to treatment and increased scheduled time on machine. Conclusion: SOFT has shown to be an acceptable and feasible alternative for traditional workflows for simple palliative radiotherapy. Future plans include offering this process for out‐of‐hours emergency treatments. References 1. O'Leary C, Cleary S, Linane H, et al. Palliative radiotherapy and the introduction of a rapid access palliative clinic in a national radiation oncology network. Ir J Med Sci 2024;193(2):577–83. 2. Cramp L, Burrows T, Surjan Y. Perceived barriers and facilitators affecting utilisation of radiation therapy services: scoping review findings ‐ patient and department level influences. Radiother Oncol 2025;204:110725. 3. O'Neil M, Laba JM, Nguyen TK, et al. Diagnostic CT‐Enabled Planning (DART): results of a randomized trial in palliative radiation therapy. Int J Radiat Oncol Biol Phys 2024;120(1):69–76. Effects of group education on bladder and bowel preparation compliance in radiation therapy prostate patients Elise Smith 1 1 Shoalhaven Cancer Care Centre, Nowra, Australia Introduction: Prostate cancer patients require an empty rectum and full bladder for radiation therapy treatment to minimise side effects to these organs. Patients who cannot meet these pre‐requisites may need multiple scans and spend more time at the cancer centre than anticipated, 1 resulting in increased anxiety, frustration and stress. 2 Additional education sessions have demonstrated enhanced understanding and improved collaboration, reducing psychological distress associated with radiotherapy. 3 This study aims to improve bladder and bowel preparation, evaluating compliance, analysis of session content quality and patient satisfaction. Methods: A pilot education program was delivered early 2025. The 90‐minute session offered detailed information on bladder and bowel preparation, featuring video footage of the linear accelerator, a former patient's experience, along with presentations from nursing, dietetics and social work. Data collection combined quantitative measures, including compliance rates and surveys, with qualitative patient feedback, analysis utilised statistical and thematic methods. Results: Patients and family members provided positive feedback, describing the program as informative and valuable. This resulted in patients experiencing less anxiety and improved compliance and understanding with preparation. In the study group, 73% strongly agreed they knew what to expect during treatment, compared to 81% of the control group who disagreed. For staff, this translated to shorter education, increased efficiency, resulting in an improved overall streamlined workflow. Conclusion: The session not only reduced anxiety and stress but also supported patients in feeling prepared and empowered for their treatment. Results suggest integrating these sessions into standard care can enhance patient and staff experience. References 1. Murland S, Paterson P, Poon W, Valiquette‐Fleury S, Piva M. Improving patient preparation for prostate radiotherapy simulation and treatment: is there anything that can be done? J Med Imaging Radiat Sci 2020;51(3):S7. https://doi.org/10.1016/j.jmir.2020.07.023 2. Bristow BJ, McGuffin M, Szumacher E, et al. Assessing the psychological impact of daily bowel preparation on prostate patients who receive radiation therapy. J Med Imaging Radiat Sci 2017;49(1):70–5. https://doi.org/10.1016/j.jmir.2017.07.004 3. Halkett G, O’Connor M, Jefford M, et al. RT Prepare: a radiation therapist‐delivered intervention reduces psychological distress in women with breast cancer referred for radiotherapy. Br J Cancer 2018;118(12):1549–58. https://doi.org/10.1038/s41416‐018‐0112‐z HART – Hauora wellbeing assessments in radiation therapy Diana Stevenson 1 1 Te Whatu Ora Waitaha – Health New Zealand, Christchurch, Canterbury, New Zealand Psychosocial distress is common among people affected by cancer and can impact both quality of life and treatment outcomes. Despite its prevalence, distress often goes unrecognised in oncology care. National guidelines, including those from Te Aho o Te Kahu (NZ Cancer Control Agency), highlight the importance of systematic screening and timely supportive care. The Hauora Assessment and Response Tool (HART) was developed to promote culturally responsive, person‐centred care in Aotearoa New Zealand. Grounded in Te Tiriti o Waitangi and Te Whare Tapa Whā, HART supports meaningful kōrero that recognises the holistic nature of wellbeing – physical, emotional, social and spiritual – and upholds Māori perspectives of hauora. This presentation shares the experience of the radiation therapy team at Christchurch Hospital in developing and implementing HART for patients undergoing radiation treatment. Collaboration with allied health professionals led to the creation of supportive care resources and successful integration of HART as standard practice. Education, ongoing support and the establishment of specialist roles were key to embedding the process. Continued partnership with social work, psychology and Kaitiaki Māori staff remains essential. Integrating HART into radiation therapy enhances holistic and culturally responsive care, enabling early recognition of distress and improved communication. It aligns practice with Te Tiriti o Waitangi, strengthens professional capability, and has improved staff satisfaction and confidence in addressing psychosocial and cultural needs. Overall, HART supports equitable, person‐centred care and continuous service development. Discovering and adapting: Development of a digital solution to PROMs integration for breast radiation therapy Paul Thomas 1,2 , Anelyn Chui 1,2 , Chen Liu 1,4,5 , Janice Yeh 1,3 , Katrina Woodford 1,2,3 1 Peter MacCallum Cancer Centre, Box Hill, Australia, 2 Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia, 3 Monash University, Melbourne, Australia To deliver patient‐centred care in radiation therapy, it is essential to capture a patient's own perspective. Traditionally, radiation therapy treatment side‐effects are monitored through clinician‐reported outcomes, overlooking symptoms that matter to patients. Patient Reported Outcome Measures (PROMs) provide a structured way for patients to report their physical wellbeing and quality of life. PROMs integration in clinical practice ensures patients have consistent engagement throughout their own treatment and follow up care. Despite their internationally recognised value for use in routine clinical care, PROMs remain underutilised in routine radiation oncology practice in Australia. 1 There are major barriers for the integration of PROMs including difficulties in collecting information from patients as well as inefficiencies in accessing the results by medical staff. 2 This feasibility study evaluates a new method for the collection of established validated PROMs integrating securely with a patients’ electronic medical record. This presentation explores the establishment of this novel way of collecting PROMs for a breast radiation oncology service across a multi‐campus Victorian cancer centre. Key aspects of the model will be discussed including design, feasibility outcomes such as completion rates and applicability of use and workflow integration. Findings from this study will inform the potential for this model to provide a scalable, sustainable framework for embedding PROMs into everyday radiation oncology care, discovering a new pathway to keep the patient experience at the centre of care. References 1. Thompson C, Sansoni J, Morris D, Capell J, Williams K. Patient reported outcome measures: an environmental scan of the Australian health care sector. Australian Commission on Safety and Quality in Health Care [Internet]. 2016. Available at https://www.safetyandquality.gov.au/sites/default/files/migrated/PROMs‐Environmental‐Scan‐December‐2016.pdf 2. Nguyen H, Butow P, Dhillon H, Sundaresan P. A review of the barriers to using Patient‐Reported Outcomes (PROs) and Patient‐Reported Outcome Measures (PROMs) in routine cancer care. J Med Radiat Sci 2021;68(2):186–95. https://doi.org/10.1002/jmrs.421 Reducing the burden of palliative radiation therapy for children with cancer through a simulation‐free pathway Katrina Woodford 1,2,3 , Alice Eriksen 1 , Laura Murphy 1 , Elena Ungureanu 1 , Michelle P Li 1,2 1 Peter MacCallum Cancer Centre, Melbourne, Australia, 2 Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia, 3 Monash University, Melbourne, Australia Introduction: When a child requires palliative radiation therapy (RT), the time from referral to treatment can be delayed due to challenges in attending or accessing an urgent planning CT, for example regional/interstate patients or younger patients requiring general anaesthesia. This study aims to explore the feasibility of simulation‐free RT (SFRT) in the palliative paediatric context. Methods: A retrospective, ethically approved, clinical audit of a large cancer centre that provides paediatric RT to Victoria and Tasmania was conducted. Palliative treatment courses (≤10#) treated between August 2018 and July 2025 with megavoltage‐RT to a solid tumour in patients <18 years of age were collected from our database. Available diagnostic imaging suitable for SFRT (<30 days old and suitable FOV) at the time of referral was documented, along with demographics, treatment details and general anaesthesia requirements. The number/proportion of courses eligible for SFRT based on a suitable diagnostic CT (dCT) or MRI scan, as well as the number requiring general anaesthesia were quantified. Results: Of 680 paediatric RT courses, 113 (17%) met study criteria. Of these, 42/113 (37%) had a suitable dCT scan available, while 37/113 (33%) only had a suitable diagnostic MRI. General anaesthesia for simulation could have been avoided on 17 occasions with SFRT. Conclusion: SFRT using a dCT, could benefit over a third of palliative paediatric patients by avoiding the need for a planning CT and in some instances general anaesthesia. The ability to plan based on a diagnostic MRI could increase the number of patients eligible for SFRT, with further work required in this area. Saturday 28 March, 4:00 PM – 5:30 PM Discovering Professional Practice (MRPBA) ‘See Something, Say Something’: Meeting the MRPBA's accreditation standards relating to image interpretation Karina Nguyen 1 , Imelda Williams 1 1 Monash University, Melbourne, Australia Introduction: The Medical Radiation Practice Board of Australia (MRPBA) reinforced its stance on image interpretation in 2019 by releasing the ‘See Something, Say Something’ policy document. 1 The MRPBA updated their Professional Capabilities for Medical Radiation Practitioners in 2020, emphasising the need to identify and convey significant findings. 2 Few studies have explored how Australian radiography training programs develop their curriculum to ensure that graduates meet this specific capability. Objectives: This study aims to examine how accredited radiography training programs in Australia teach and assess image interpretation skills; and explore possible variability across the respondents. Methods: A Qualtrics survey was distributed to the heads of department/program directors of 11 Australian universities offering radiography training programs. Document analysis was used to identify common themes and differences among the programs. Results: A total of 7/11 (64%) responses were received. Of these, only six with completed responses (n = 6/11, 55%) were included. Only three (n = 3/6, 50%) respondents introduced image interpretation from the first year. Six key themes emerged following thematic analysis: 1) clinical indications; 2) image quality; 3) human anatomy; 4) radiographic anatomy and pathology; 5) critical thinking and decision making; and 6) communication. Communicating radiographic findings and assessment tasks demonstrated the most differences. Conclusion: The results indicated similarities and variability in how image interpretation is delivered and assessed across Australian universities. Communication and approaches to assessment showed the greatest variability. National curriculum standardisation may strengthen the consolidation and transferability of image interpretation skills for clinical practice, thereby aligning with the MRPBA capability framework and promoting the delivery of safer and more effective patient care. References 1. Medical Radiation Practice Board of Australia. 2020. Professional capabilities for medical radiation practitioners. Available at https://www.medicalradiationpracticeboard.gov.au/Registration‐Standards/Professional‐Capabilities.aspx 2. Medical Radiation Practice Board of Australia. 2019. Policy: Communicating safely – if urgent or unexpected findings are seen. Available at https://www.medicalradiationpracticeboard.gov.au/documents/default.aspx?record=WD19%2f29234&dbid=AP&chksum=YWiqv5N%2b0D4D49ZOhi8LCA%3d%3 . Accessed 28 February 2025 Collecting what matters: Improving equity data in cancer care Vikneswary Batumalai 1,2 , Mei Ling Yap 1,2 1 The George Institute for Global Health, UNSW Sydney, Sydney, Australia, 2 School of Clinical Medicine, UNSW Sydney, Sydney, Australia Achieving equity in cancer care begins with recognising that race, ethnicity and language matter. The absence of robust, systematically collected demographic data limits our ability to identify disparities, understand variations in outcomes, and design targeted interventions that improve access and quality of care. Across the cancer continuum, from screening and diagnosis to treatment, survivorship and palliative care, populations from diverse backgrounds often experience barriers related to communication, cultural understanding and system navigation. Yet many health datasets fail to capture race, ethnicity and language information in a consistent and structured way, particularly in settings where data systems are still evolving. Without this information inequities remain unseen and opportunities for improvement are missed. This presentation explores the global challenges and practical solutions for improving race and ethnicity data collection. Radiation therapists are well positioned to help address this gap. Their close, ongoing interactions with patients provide key opportunities to strengthen the collection of equity‐related data. Radiation therapists can help normalise these discussions by using respectful, transparent communication and clearly explaining the purpose of data collection. Embedding race, ethnicity and language fields into standard intake forms and advocating for their inclusion in electronic medical records can prevent data gaps and ensure routine capture. Training in culturally safe communication, regular data audits and collaboration within multi‐disciplinary teams can further enhance data quality. By championing complete and accurate demographic data, radiation therapists contribute to a stronger evidence base for equity‐informed care and play a vital role in building a fairer, more inclusive cancer care system. The Advanced Practice Pathway: Revised edition for medical radiation sciences Alison Brown 1 , Angelina Piccolo 2 , Johnathan Hewis 3 1 Western Sydney Local Health District, Sydney, Australia, 2 Monash University, Melbourne, Australia, 3 Charles Sturt University, Port Macquarie, Australia The official Advanced Practice (AP) Pathway was first released by the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT) in 2014, following more than a decade of work by successive working parties and stakeholder engagement dating back to 2002. 1 ASMIRT was the first professional body in the field of medical radiation sciences to release an official pathway and accreditation process. Despite this, AP roles in Australia has progressed slowly. 2 As AP continues to gain momentum internationally within medical radiation sciences, 3 and across other allied health professions, as well as in nursing, it is essential that the pathway and accreditation processes remain current. Doing so ensures these skilled roles retain credibility and integrity, aligning with evolving international standards. The ASMIRT Advanced Practice Reference Group has built on the original document to develop a revised pathway. This updated framework provides clearer definitions of AP and more robust guidance around accreditation and assessment. While the primary focus remains on AP, the revised pathway also introduces definitions for enhanced and consultant practice, in line with international models and future directions for the profession. By offering greater clarity, these updated guidelines aim to support both professionals pursuing AP roles and workforce managers integrating these high‐value positions into healthcare settings. References 1. Australian Society of Medical Imaging and Radiation Therapy. 2017. Pathway to advanced practice: advanced practice for the Australian medical radiation profession. 2. Hilder B, Van Dam P, Doherty K. Advanced practice radiation therapists: an Australia context. J Med Radiat Sci 2018;65:137–47. 3. Nocum D, Hewis J. A global evaluation of advanced practice recognition pathways for diagnostic radiography. Radiography 2025;31:102923. https://doi.org/10.1016/j.radi.2025.102923 Saturday 28 March, 4:00 PM – 5:30 PM Navigating Trauma Response Waiting for Alfred: Preparations for Tropical Cyclone Alfred Sally Ball 1 1 Princess Alexandra Hospital, Brisbane, Australia On 3 March 2025, the Bureau of Meteorology issued a cyclone watch for the greater metropolitan area of Brisbane due to Tropical Cyclone Alfred. More than 4 million people were in its path, making it the largest population potentially impacted by a cyclone in Australia. The medical imaging department of a major tertiary referral hospital listened to the warnings and was required to prepare for Cyclone Alfred. This included planning staffing and resources for the duration of the cyclone to ensure all services were covered, along with preparations for the aftermath when it was uncertain what impact Cyclone Alfred would cause. There were many unknowns to prepare for, including how long staff would be required to stay onsite and the ability of staff being able to reach the hospital after the event. Preparation for Cyclone Alfred proved to be challenging, partly due the changing timeline of when it was expected to cross the coastline. Management and staff needed to be adaptable – as fast as plans were made, they needed to be unmade due to the changing timelines of Alfred. This presentation covers the steps undertaken to prepare staffing to ensure continuity of service, the steps taken to keep all staff informed, and the lessons learnt from the process. While it may be 50 years before another cyclone hits Brisbane, we can all learn discover lessons for being prepared for when disaster strikes. The wounded healer Edel Doyle 1 , Lindsay Batty‐Smith 2 1 The International Association of Forensic Radiographers – Australian and New Zealand Branch, Melbourne, Australia, 2 The International Association of Forensic Radiographers – United Kingdom Branch, London, United Kingdom The 'pain we’re in' looks at the way in which radiographers are repeatedly exposed to pain and tragedy as part of the work they are involved in, and the possible effects that may arise. Radiographers tend not to look at the emotional issues surrounding and emanating from their work. We are good at the technological aspects, but are we good at looking after our emotional welfare? Do we question why we do what we do? Do we learn from events and improve our practice or do we just soldier on? We hope to highlight and inform our practice using the ‘wounded healer concept’ to explore this subject. Navigating emotions in forensic imaging Edel Doyle 1 1 The International Association of Forensic Radiographers – Australian and New Zealand Branch, Melbourne, Australia Forensic imaging is a postgraduate competency, 1 as professional experience and emotional intelligence are necessary foundations. As clinical radiographers, we may feel upset or affected in some way by individual cases such as a complex trauma patient, a patient with an acquired brain injury, or a paediatric patient where there is a suspicion of non‐accidental injury. Understanding what motivates us to be involved in this specialist area of imaging is important so that we can then recognise if or when we are struggling. In some situations, the emotions of family members may be heightened, and this can also have an impact on our ability to perform our professional role. Being aware of and being able to recognise the signs and symptoms of post‐traumatic stress disorder in ourselves and our colleagues is important. 1 Learning how to navigate all of these emotional situations is key to maintaining a positive mental attitude. Reference 1. Doyle E, Hunter P, Viner MD, et al. IAFR Guidelines for best practice: principles for radiographers and imaging practitioners providing forensic imaging services. Forensic Imaging 2020;22:200400 27 siblings and counting – What I learned about supporting patients with medical trauma Rebecca Kilday 1 , Hayley Smith‐Williams 2 1 Top End Regional Health Service, Darwin, Australia, 2 Donor Conception Advocate, Victoria, Australia The lived experiences of donor‐conceived people (DCP) often involve navigating a complex emotional landscape shaped by the medical systems that facilitated their conception. Because of the historical anonymity of sperm and egg donors, adult DCP experience conflicting narratives about what is known about them, who holds that information and who has the right to know. 1,2 For many this can foster a sense of alienation and disempowerment arising from limited access to crucial health‐related information about their genetic heritage and identity, in addition to the potential for serious health implications of unknown disease risk profiles. 2 This is often compounded by a lack of focus on the unique needs of DCP. Medical trauma resulting from such experiences can lead to lasting distrust and suspicion of medical systems. These experiences are not unique to DCP and are well documented as a contributor to healthcare disparities, especially in the context of systems that fail to practice culturally sensitive care environments. 3 For patients experiencing medical trauma, the failure to provide care that is both culturally sensitive and person‐centred can deepen the sense of disconnection and hinder their willingness to engage with future health care. Radiographers, as frontline healthcare workers, have a unique opportunity to either alleviate or exacerbate trauma through their interactions with patients. Imaging can be a particularly distressing experience especially when procedures are invasive, uncomfortable or emotionally charged. By adopting a person‐centred approach, radiographers can help create a supportive environment, providing clear explanations, offering emotional support and ensuring patient dignity is maintained. 4 References 1. Kramer W. Bypassing trauma in donor‐conceived people ‐ the power of early disclosure and donor family connections to reduce trauma. Psychology Today Blog. September 18, 2024. Available at https://www.psychologytoday.com/au/blog/donor‐family‐matters/202409/bypassing‐trauma‐in‐donor‐conceived‐people 2. Burke R, Lavery YO, Katznelson G, North J, Boyd JW. How do individuals who were conceived through the use of donor technologies feel about the nature of their conception? Biotechnology 2021. 3. Tujague N, Ryan K, editors. Sharing trauma knowledge: types of trauma. In: Cultural safety in trauma‐informed practice from a first nations perspective. Palgrave Macmillan, Cham; 2023. 4. Chau S, editor. Person‐centred care in radiology: international perspectives on high‐quality care. CRC Press; 2024. Saturday 28 March, 4:00 PM – 5:30 PM Exploring Clinical Education Addressing placement poverty: Targeted grant support for final‐year medical radiation science students during clinical placements Eileen Giles 1 1 The University of South Australia, Adelaide, Australia Introduction: Clinical placements are an essential component of medical imaging, radiation therapy and nuclear medicine education, providing students with hands‐on experience in real‐world settings. However, many students experience significant financial hardship during placements. Known as ‘placement poverty’, 1 this issue affects healthcare students across Australia, with costs for travel, accommodation and living expenses often exceeding their financial means and contributing to stress and delayed course completion. Objective: This initiative aimed to provide targeted financial support to medical radiation science students undertaking final‐year clinical placements and to highlight the need for broader, systemic funding support for placement‐related costs. Methods: Following advocacy from the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT) for medical radiation science inclusion in the forthcoming Commonwealth Prac Payment, 2 an interim funding program was developed. Based on an audit of student numbers across 11 universities offering medical radiation science programs, ASMIRT approved 90 placement support grants of $500 each (total $45,000). Grants were advertised through universities, social media and ASMIRT e‐blasts. Applicants completed an online form describing the financial impact of placement. Results: A total of 161 applications were received. After a robust selection process, 90 students were awarded funding to assist with general cost‐of‐living expenses incurred during placement. Conclusion: This initiative provided meaningful relief for students experiencing placement‐related financial stress. Continued advocacy is essential to ensure that future Commonwealth Prac Payments are extended to medical radiation science students, supporting equitable access to clinical training and sustaining Australia's medical radiation workforce. References 1. ABC News. 2024. Government moves to fund students on university placements for teaching, nursing and social work. Available at https://www.abc.net.au/news/2024‐05‐05/placement‐poverty‐commonwealth‐payment‐nurses‐teachers/103807024 2. Australian Government. 2024. New Commonwealth Prac Payment fact sheet. Available at https://www.education.gov.au/about‐department/resources/new‐commonwealth‐prac‐payment Constructing a collaborative education culture: First‐year achievements of a radiology education team Luke Monsour 1 1 Monash Health, Melbourne, Australia Introduction: In 2024, we identified a need for enhanced education, consistency and upskilling across our network. To address this, a collaborative education team was established, uniting modality‐specific educators to strengthen clinical learning, professional development and staff engagement across a large tertiary service. Objective: To outline the implementation and impact of the imaging education team, with emphasis on achievements within the general and fluoroscopy education stream. Methods: A multi‐modality approach was adopted to create a cohesive framework for education delivery. Initiatives included comprehensive updates to training manuals and resources, structured CPD programs, cross‐modality workshops and communication tools to connect staff and promote a culture that encourages engagement in education and continuous learning. Results: Since the team's formation, several outcomes have been achieved: a department‐wide newsletter was introduced to share updates, achievements and learning opportunities a multi‐modality workshop series was established, fostering collaboration across imaging disciplines and providing accessible CPD opportunities within the general/fluoroscopy stream, extensive resources were created, including detailed training manuals, structured CPD calendars and competency tools. These initiatives led to a measurable increase in CPD participation, improved accessibility of educational materials, and stronger engagement across the department. Conclusion: The creation of the imaging education team has strengthened educational consistency, engagement, and collaboration across modalities. While there are still many areas to develop and improve, the structured approach and resource development within the general/fluoroscopy area have contributed to a sustainable culture of learning and professional excellence within a large tertiary network. Supporting and mentoring MRS students during challenging times: A toolkit for clinical supervisors Natalie Pollard 1 1 Queensland University of Technology, Brisbane, Australia Medical radiation science students are at the cornerstone of our future profession. The aim of clinical education is to create a supportive learning environment 1 where medical imaging and radiation therapy students can grow and thrive, both personally and professionally. However, students are often managing a range of complexities while undertaking a clinical placement, including (but not limited to) a physical and/or mental health condition, financial difficulties or a primary carer responsibility. Clinical supervisors are tasked with facilitating students’ learning during a clinical placement while balancing the needs of students against an increasingly complex patient caseload. This has the potential to create significant stress and an increased workload for clinical supervisors if the student is experiencing difficulty on placement. This presentation will provide clinical supervisors with a toolkit of how to identify a student who is experiencing difficulty on placement – including cues that a student is struggling, 2,3 principles of early intervention, and effective strategies that clinical supervisors can implement to support medical radiation science students in their professional development. Additionally, this presentation will explore how universities work with both the student and clinical supervisor (triadic relationship) to support both parties. This presentation will be of interest to all clinical supervisors who are seeking to expand their knowledge to build a culture of learning, guidance and support to empower the next generation of medical radiation professionals. References 1. Rusticus S, Pashootan T, Mah A. What are the key elements of a positive learning environment? Perspectives from students and faculty. Learning Environments Research 2023;26:161–75. 2. Armstrong‐James L, Khine R, Thorne R, Tuckey M, Bennett C. Radiotherapy students’ perceptions of support provided by clinical supervisors. J Radiotherapy Pract 2020;19(1):15–9. 3. ClinEdAus. 2025. Managing the underperforming student. Available at https://www.clinedaus.org.au/topics‐category/managing‐the‐underperforming‐student‐215 A ‘painful’ lesson: Conceptual change theory as a guide for clinical education Sophie Shephard 1 , Kate Dahlenburg 2 1 Charles Sturt University, Wagga Wagga, Australia, 2 Logan Hospital, Meadowbrook, Australia Clinical education can feel like a wilderness, dense with existing knowledge, entrained practices and ever‐growing evidence. Learning is complex, requiring much more than just providing new information. Learners bring their own maps, formed from prior experiences and understandings. These maps may not always be up‐to‐date or accurate, and where they conflict with new evidence, educators must help learners to interrogate and redraw their maps. To this end, ‘conceptual change theory’ can act as a compass, helping educators navigate existing misconceptions, creating appropriate cognitive conflict to enable construction of new knowledge. 1 This presentation draws on conceptual change theory to explore the personal story of the presenters – two sisters, one a radiographer, the other a pain physiotherapist – whose casual conversations about pain science evolved into a long and unexpected learning journey. Together, they reflect on what helped (and what didn’t), how listening and adapting the educational approach to accommodate existing misunderstandings supported deep learning, and how the process transformed into a shared passion and ongoing interprofessional collaboration. While this example focusses on pain science, the lessons extend far beyond. In radiography, as in all areas of health care, learners bring with them their own mental maps that influence how they interpret and integrate new information to update their professional practice. These pre‐existing frameworks can both help and hinder learning. Drawing on conceptual change theory can assist educators to better recognise and work with these tensions, and to navigate the wilderness of clinical education with curiosity and adaptability for better learning outcomes. Reference 1. Chi MT. Three types of conceptual change: Belief revision, mental model transformation, and categorical shift. In: Vosniadou S, editor. International handbook of research on conceptual change. 1st edn. Routledge; 2008. https://doi.org/10.4324/9780203154472 Discovering the perception of empathy in medical imaging Pauline Hext 1,2 1 Health NZ, Auckland, New Zealand, 2 Allevia Radiology, Auckland, New Zealand Introduction: Clinical empathy requires an understanding of the patient's perspective and being able to adapt to the patient's needs to ensure patient‐centred care. Empathy in the clinical setting has many positive attributes which in turn improve patient outcomes. The question asked in this study was: What is the perception of empathy for medical imaging students in the clinical setting? Methods: Purposive sampling included third‐ and fourth‐year medical imaging students based at a single clinical site. A qualitative design was used to explore the participants' perception of empathy. Participants were presented with patient scenarios to explore their perception of empathy and how they adapted their clinical practice according to the scenario. Data were analysed using thematic analysis. Results: Although students had a sound theoretical knowledge of empathy it was the application of empathy in the clinical setting that enabled students to gain a deeper understanding of the notion of empathy and the challenges associated with ‘being empathetic’. In the quest to enhance empathy in interactions with patients, students faced several challenges, including inadequate time with patients, patients not agreeing to students performing their examination, and limited student experience. On reflection, students recognised the need to better understand the concept of empathy and its application in the clinical setting. Conclusion: Empowering students to explore empathy leads to a heightened awareness of patient needs in the clinical setting. A further study will be required to determine if this improved rapport in patient‐student interactions ensures patient‐centred care. Educating for change: Preparing a medical imaging workforce for a new hospital opening Jessica Watson 1 1 Western Health, Melbourne, Australia The transition to a new hospital requires more than new equipment and facilities; it demands intentional educational leadership to guide staff through significant change. This presentation explores the educator's role in planning, delivering and adapting a comprehensive training program to prepare a medical imaging workforce for a major hospital transition. Effective change management began with understanding the workforce and advocating for their needs throughout the planning stages. Establishing clear communication channels and key contacts across disciplines ensured that education was aligned with both operational requirements and staff readiness. Early involvement in planning meetings provided insight into new terminology, workflows and equipment, allowing the ability to tailor training content accordingly. Structured tours of the new facility were integrated into the learning process, helping staff visualise new environments and identify potential challenges before go‐live. A crucial component was supporting staff to understand and adapt to areas outside their usual practice scope. This broadened their awareness of the wider imaging service and promoted flexibility in a dynamic environment. This presentation highlights how proactive educational leadership can transform organisational change into an opportunity for professional growth. The lessons learned offer practical strategies for educators seeking to balance workforce preparedness, advocacy and engagement during large‐scale service transitions. Saturday 28 March, 4:00 PM – 5:30 PM Student Prize Winners (MI) Exploring burnout among undergraduate medical radiation science students in Australia: A literature review Alana Brkic 1 , Hashini Senadeera 1 , Isabella Larobina 1 1 The University of South Australia, Adelaide, Australia Introduction: Burnout – defined as emotional exhaustion, depersonalisation and a reduced sense of accomplishment – is increasingly prevalent in students and linked to poorer academic performance, reduced wellbeing and higher attrition rates. 1 Burnout manifests as fatigue, cynicism and inefficacy attributed to chronic academic pressure and unsustainable demands. 2 While well‐studied in healthcare professionals, limited research has addressed burnout in medical radiation science (MRS) students specifically, who face unique challenges including prolonged clinical placements, patient care responsibilities and adaptation to high‐stakes technical environments. This review aimed to explore the literature regarding burnout among undergraduate MRS students in Australia. Methods: Electronic databases including Medline, Scopus and CINAHL were searched for studies published in English from 2010 that explored students' perceptions and experiences of burnout in undergraduate MRS programs using qualitative or quantitative methods. Key data on reported risk factors and recurring themes of burnout were extracted and summarised through narrative synthesis. Publicly available information on clinical placement requirements from accredited Australian MRS programs was reviewed to provide contextual insight. Results: There exists a wide range of stressors involving academic, clinical and socioeconomic factors relevant to the undergraduate MRS student context. Thematic analysis identified recurring contributors to burnout among MRS students including workload intensity, financial stress, placement expectations and the emotional demands of clinical work. Conclusion: This review highlights the multifaceted nature of burnout among Australian undergraduate MRS students, driven by a combination of academic, clinical and socioeconomic stressors. Understanding these factors is essential to inform targeted strategies that support student wellbeing and promote workforce retention. References 1. Vivolo M, Owen J, Fisher P. Psychological therapists' experiences of burnout: a qualitative systematic review and meta‐synthesis. Mental Health & Prevention 2024;20(33). https://doi.org/10.1016/j.mhp.2022.200253 2. Chong LZ, Foo LK, Chua SL. Student burnout: a review on factors contributing to burnout across different student populations. Behav Sci 2025;15(2):170. Assessing the value of weightbearing and gravity stress radiographs in evaluating instability of Weber B fractures Neve Joseland 1 1 Deakin University, Melbourne, Australia Research Question: Are weightbearing and gravity stress radiographs both equally valid in assessing syndesmosis widening and ankle stability in Weber B fractures? Objectives: Evaluation of the diagnostic accuracy of weightbearing and gravity stress radiographs in detecting syndesmotic instability. To determine whether these radiographic views influence clinical decision‐making and treatment planning. Methods: A systematic literature review was conducted, focussing on studies evaluating the use of weightbearing and gravity stress radiographs in assessing syndesmosis widening. Databases such as PubMed were searched using keywords such as "Weber B fracture", "syndesmosis widening", "weightbearing radiographs", and "gravity stress views". Inclusion criteria included both retrospective and prospective studies published within the past two decades, involving adult patients with Weber B fractures. Study Significance: Accurately assessing syndesmotic stability in Weber B fractures is critical for guiding treatment decisions. This study will contribute to the ongoing discussion regarding optimal radiographic evaluation techniques for ankle stability assessment and may influence clinical protocols for managing Weber B fractures. Expected Outcomes: A comprehensive understanding of the role and limitations of weightbearing and gravity stress radiographs in evaluating syndesmotic widening. Identification of potential gaps in current research and areas requiring further investigation. Recommendations for clinical best practice. Conclusion: The use of weightbearing and gravity stress radiographs in assessing syndesmosis widening in Weber B fractures remains debated. By synthesising current literature, this study aims to clarify their diagnostic value, ultimately aiding in the refinement of management strategies. Left waiting, left behind: The unmet necessity for equitable imaging in rural and regional Australia Charlotte Mccaughan 1 1 Charles Sturt University, Wagga Wagga, Australia Australians living in regional and rural communities remain trapped in a health equity crisis where access to timely diagnosis is dictated by geography rather than need. Compared to metropolitan populations, people outside major cities experience poorer health outcomes, higher hospitalisation rates and limited access to essential services. 1 Diagnostic imaging is no exception. In 2022–23, Medicare‐subsidised imaging reached 39% of patients nationally, yet only about half of those in very remote areas accessed such services, compared to 65–70% in cities. 1,2 This reveals a postcode lottery where the chance of diagnosis depends on location. The consequences are profound. Delayed or absent access to MRI, CT and other essential imaging services results in late cancer detection, interrupted treatment plans and preventable suffering. Families are forced to shoulder financial burdens, travel hundreds of kilometres, or forgo care entirely. 2 Such disparities entrench cycles of poor health and deepen the divide between city and country. In recognition of this inequity, the 2022–23 Federal Budget pledged $66 million to deregulate Medicare‐funded MRI services across Modified Monash Model zones 2–7, aiming to reduce travel and out‐of‐pocket costs. 3 While welcome, this measure alone cannot dismantle decades of systemic neglect. Equitable access to diagnostic imaging is not an optional improvement, it is a fundamental right. Rural Australians must no longer pay with their health for the tyranny of distance. To uphold fairness and dignity, diagnostic imaging must be delivered as a core pillar of universal health care, not a privilege reserved for metropolitan postcodes. References 1. Australian Institute of Health and Welfare. Rural and remote health [Internet]. 2024. Available at https://www.aihw.gov.au/reports/rural‐remote‐australians/rural‐and‐remote‐health 2. Australian Institute of Health and Welfare. 2024. Pathology, imaging and other diagnostic services [Internet]. Available at https://www.aihw.gov.au/reports/diagnostic‐services/pathology‐imaging‐and‐other‐diagnostic‐services 3. Australian Government Department of Health. 2022. Primary Health Care 10 Year Plan – stronger rural health strategy – improving rural access to magnetic resonance imaging (MRI) diagnostics [Internet]. Available at https://www.health.gov.au/sites/default/files/documents/2022/03/budget‐2022‐23‐improving‐rural‐access‐to‐magnetic‐resonance‐imaging‐mri‐diagnostics.pdf Pilot feasibility study assessing immersive MRI training to improve undergraduate radiography competence and safety Sarah Shipman 1 1 Curtin University, South Perth, Australia Introduction: The pilot program aimed to bridge the gap between theoretical MRI education and clinical practice for undergraduate medical radiation science students. 1 It sought to enhance technical competence, confidence and awareness of MRI safety protocols. 1 Early hands‐on exposure was intended to ensure students develop the professional responsibility required to maintain patient and staff safety in high‐risk MRI environments. The importance of this was highlighted by the tragic death of Keith McAllister in the United States in July 2025, when his ferromagnetic chain was pulled into an MRI scanner. 2 Methods: Following completion of a theoretical MRI unit, 10 second‐ and third‐year medical radiation science students participated in a 2‐week hands‐on MRI program. 1 Activities included phantom and peer scanning, workshops covering MRI safety, anatomy protocols, gadolinium, physics instrumentation and adapting image acquisition factors. 1 Participants were assessed before and after the program using a 38 question knowledge test and a 5‐point self‐rated competence scale. 1 Results: Knowledge scores improved from approximately 35% pre‐program to 63% post‐program, and self‐rated competence increased from 2.80 to 3.20. 1 Despite the small sample size, these findings demonstrate that hands‐on MRI experience is feasible and significantly enhances both confidence and technical skills. 1 Conclusion: Structured hands‐on MRI education should be integrated earlier in radiography curricula to build competence, confidence and a culture of safety. Early exposure ensures students internalise critical safety protocols, bridging the gap between theory and clinical practice, and preparing them to prevent accidents in high‐risk MRI environments. References 1. Ng CKC, Vos S, Moradi H, et al. Innovative hands‐on approach for magnetic resonance imaging education of an undergraduate medical radiation science course in Australia: a feasibility study. Educ Sci 2025;15(7):930. https://doi.org/10.3390/educsci15070930 2. Society of Radiographers. 2025. SOR highlights importance of MRI safety after death. Available at https://www.sor.org/news/mri/sor‐highlights‐importance‐of‐mri‐safety‐after‐deat Split‐bolus dual‐energy CT urography – Evaluation of radiation dose and diagnostic performance Merissa Wong 1 1 Queensland University of Technology, Brisbane, Australia Introduction: Haematuria, or blood in the urine, is a common clinical indication for performing multi‐phasic CT urography scans, which typically consist of non‐contrast, nephrogenic and excretory phases. Split‐bolus dual‐energy CT (SBDECT) offers the ability to perform CT urography (CTU) as a single‐phase study, reducing the overall radiation dose. This narrative review investigates the clinical use of SBDECT on radiation dose and image quality and explores additional benefits and limitations of this technique. Methods: Three databases (Embase, Scopus, ScienceDirect) were searched using keywords including “split‐bolus” and “CT urography” to identify relevant English‐language studies published between January 2020 and August 2025. Discussion/Conclusion: Existing literature strongly supports the use of SBDECT in reducing radiation dose for CTU. The exact amount of dose reduction depends on several factors including the patient's body mass index and scan protocol. In terms of image quality, some studies suggest there were no significant differences between SBDECT and the conventional multi‐phasic CTU. Some studies, though, show that SBDECT had better contrast enhancement of the urinary tract, while others show that SBDECT had lower sensitivity for detecting renal stones. Additionally, SBDECT can be used to quantify iodine concentrations and generate iodine maps, which can be used in characterising certain renal lesions. However, literature evaluating the impact of SBDECT on workflow efficiency is limited. While there is strong evidence for SBDECT in dose reduction, further research is required on image quality, the accuracy of iodine maps and scan time to determine the diagnostic efficacy and clinical value of SBDECT in CTU. Saturday 28 March, 4:00 PM – 5:30 PM Student Prize Winners (RT) One visit is all it takes: Single fraction SBRT for lung cancer in rural health Jacob Clarke 1 1 University of Newcastle, Newcastle, Australia Introduction: Western NSW Local Health District (WNSWLHD) is the largest local health district in New South Wales, with 11% of the population being of Aboriginal and Torres Strait Islander background. 1 Lung cancer is the leading cause of cancer death in indigenous communities (1 in 4 cancer deaths). 2 This study aimed to investigate the use of single fraction stereotactic body radiation therapy (SF‐SBRT) in early‐stage lung cancer. Method: This retrospective cohort study reviewed patients who underwent lung cancer SBRT treatment at WNSWLHD between June 2024 and July 2025. For each patient a SF‐SBRT plan with a dose of 28 Gy was created and compared against the original multi‐fraction SBRT (MF‐SBRT) plan (48 Gy/4fx or 50 Gy/5fx). Dosimetric feasibility of SF‐SBRT was assessed and patient factors such as geographical location, demographics and comorbidities were also considered. Results: 17 patients were included in the study. Average distance travelled for treatment was 98 km and 6% identified as Aboriginal. SF‐SBRT demonstrated a decreased dose to key organs at risk. Chest wall D70 cm 3 constraint (11.43 Gy SF vs 20.16 Gy MF) and lung V5 Gy (8.93% SF vs 13.22%). SF‐SBRT achieved an optimal dose coverage with average internal target volume coverage of 99.98% SF vs 99.99% MF as well as improved planning volume target coverage from 97.69% MF to 99.77% SF. Conclusion: The study found similar or improved dosimetric results when comparing SF‐SBRT versus MF‐SBRT indicating the possible utilisation of SF‐SBRT for future lung cancer treatment. This is particularly beneficial for rural and remote patients who face geographical barriers when accessing multi‐fraction treatments. References 1. District WNLH. 2022. About Western NSW Local Health District | NSW Government [Internet]. Available at https://www.nsw.gov.au/departments‐and‐agencies/wnswlhd/about‐us 2. Garvey G. NU01.05 Indigenous population with lung cancer. J Thor Oncol 2017;12(1):S195–6. Postcode prescriptions: How geographical location shapes radiation therapy diagnosis and treatment wait times Kristyn Fuller 1 1 Queensland University of Technology, Brisbane, Australia Introduction: Approximately 30% of the Australian population live over 180 km from tertiary healthcare facilities. 1 Residents in these rural and remote locations are more likely to be diagnosed with low survival rate cancers and die within 5 years of diagnosis. 2 The aim of this literature review is to determine the effect of geographical location on diagnosis and wait times for radiation therapy. Methods: Databases including PubMed, Scopus and Embase were searched for peer‐reviewed studies between 2010–2025. A PRISMA flow diagram was used to evaluate sources which included systematic reviews, randomised controlled trials, cohort studies and meta‐analyses and include six final studies. Included studies explored the disparities in radiation therapy diagnosis and treatment wait times in Australia. Results: Geographical location undoubtedly affects radiation therapy diagnosis and treatment wait times with rural and regional patients experiencing either comparable or increased wait times when compared to urban. Evidently, the most significant finding was the consistent disparity in the treatment interval (diagnosis to initial definitive management) for rural patients, with statistically significant delays identified in majority of studies, except for two. Median wait times were consistently longer for rural patients across most intervals, however, differences in diagnostic and referral intervals were generally comparable and not statistically significant. Conclusion: Rural patients experience evident delays in diagnosis and radiation therapy treatment wait times compared to those in urban areas, highlighting unacceptable inequalities largely affected by place of residence. Further investigation into individual tumour types and the effect of public versus private treatment facilities is warranted to enhance understanding of these disparities. References 1. Coyne E, Frommolt V, Salehi A. The experience and challenges of rural persons with cancer and their families. Collegian 2019;26(6):609–14. https://doi.org/10.1016/j.colegn.2019.10.002 2. Rynia N. Cancer outcomes in regional Australia [Internet]. Pancare Foundation; 2020. Available at https://pancare.org.au/cancer‐outcomes‐in‐regional‐australia/ Intensity range algorithm evaluation for online brain image‐guided radiation therapy Brooke Mander 1 , Catriona Hargrave 1,2 , Benjamin MacFarlane 3 , Bernadette Byrne 3 1 Queensland University of Technology, Brisbane, Australia, 2 Princess Alexandra Hospital, Brisbane, Australia, 3 W.P. Holman Clinic, Launceston General Hospital, Launceston, Australia Introduction: There are various automatic registration algorithms used to register the daily cone beam CT (CBCT) scan with the reference CT scan. 1,2 This study aims to determine whether the structural intensity range algorithm available in the Varian system software can produce equivalent or superior image match results to bone contour‐based volume of interest image registration for brain image‐guided radiation therapy. Methods: This retrospective study included the planning CT and CBCT images of 20 patients who had undergone a course of brain radiation therapy. Each CBCT image was registered to the planning CT using both bone contour‐based image matching and the structural intensity range algorithm, and the associated translational and rotational couch shifts were recorded. Descriptive and exploratory statistics were used to compare the couch shifts between the two registration methods. Results: The data showed minimal difference in the couch shifts between bone contour‐based image matching and the structural intensity range algorithm, with the largest difference seen in the superior/inferior direction (mean = –0.02 mm). Spearman's rank correlation coefficient and intraclass correlation demonstrated excellent correlation and agreement, yielding outputs greater than 0.9 for all directions. Furthermore, Bland‐Altman plots demonstrated high agreement between the two registration algorithms for all directions, with 95% of the shift differences within 0.2 mm and 0.2 degrees. Conclusion: The structural intensity range algorithm produces image match results equivalent with those of bone contour volume of interest‐based image registration for brain radiation therapy, eliminating the need to create additional contours in the image‐guided radiation therapy workflow. References 1. Mohandass P, Khanna D, Nishaanth B, et al. Impact of three different matching methods on patient set‐up error in x‐ray volumetric imaging for head and neck cancer. Rep Pract Oncol Radiother 2020;25(6):906–12. 2. Choi GW, Suh Y, Das P, et al. Assessment of setup uncertainty in hypofractionated liver radiation therapy with a breath‐hold technique using automatic image registration‐based image guidance. Radiat Oncol 2019;14(1):154. Low‐dose radiation therapy for conjunctival extranodal marginal zone lymphoma: A case report Chris Nguyen 1 1 RMIT University, Melbourne, Australia Introduction: Conjunctival extranodal marginal zone lymphoma (EMZL) is a rare subtype of mucosa‐associated lymphoid tissue lymphoma, comprising 1% of non‐Hodgkin lymphomas. Despite its rarity, it is the most common primary orbital malignancy in adults, accounting for 55% of ocular lymphomas. Case Presentation: A 51‐year‐old male presented in 2022 with a left medial conjunctival lesion. Histopathology confirmed stage IAE EMZL following excision, and baseline PET‐CT showed no systemic involvement. He was managed with a watch‐and‐wait approach. Three years later, the EMZL recurred at the same site. Diagnostic workup also identified concurrent Sjögren's syndrome, an autoimmune condition that heightens ocular radiation sensitivity. 1 Management/Outcome: Given the risk of radiation‐related ocular toxicity, doxycycline was introduced as a low‐risk alternative to radiotherapy. It was well tolerated but ineffective and discontinued before definitive treatment. Ultra‐low‐dose radiotherapy (4 Gy in 2 fractions) was delivered, with salvage radiotherapy (24 Gy in 12 fractions) planned as a last resort. 2,3 Current literature suggests very low dose radiation therapy achieves complete response rates around 85% and durable local control of roughly 75% at 2 years with minimal toxicity. 4 Discussion: This case highlights the impact of autoimmune comorbidity on treatment selection for conjunctival EMZL. It supports the use of doxycycline as a safe first‐line option and demonstrates how ultra‐low‐dose radiotherapy can offer an effective, organ‐sparing approach for patients at higher risk of ocular toxicity. References 1. Kanazawa H, Kawasaki K, Miyamoto I, et al. MALT lymphoma of the palatal minor salivary grand in patient with Sjögren's syndrome: a case report. Oral Maxillofac Surg Cases 2023;9(4):100336. 2. Tanenbaum RE, Galor A, Dubovy SR, Karp CL. Classification, diagnosis, and management of conjunctival lymphoma. Eye Vis 2019;6:22. 3. Pinnix CC, Dabaja BS, Milgrom SA, et al. Ultra‐low‐dose radiotherapy for definitive management of ocular adnexal B‐cell lymphoma. Head Neck 2017;39(6):1095–100. 4. Fasola CE, Jones JC, Huang DD, et al. Low‐dose radiation therapy (2 Gy × 2) in the treatment of orbital lymphoma. Int J Radiat Oncol Biol Phys 2013;86(5):930–5. mHealth applications in radiation oncology: Australian radiation therapists' perspective Constance Raymond 1 , Mikaela Dell'Oro 1 1 Curtin University, Bentley, Australia Introduction: mHealth applications for smart devices represent a growing trend in enhancing healthcare delivery, ultimately leading to improved health outcomes and patient experiences. 1,2 However, there is a gap in mHealth applications tailored specifically to the radiation oncology experience in Australia. 3 This study aims to explore the current perspectives of Australian radiation therapists to inform the development of future mHealth applications that align with views of the professional community. Methods: This study used a mixed methods online survey to assess the perceived benefits and barriers for implementation of mHealth applications from the perspective of Australian radiation therapists from January to April 2025. The 12‐question survey combined multiple choice and Likert scaled questions with optional free‐text fields for qualitative data collection. Quantitative data underwent descriptive statistics, Kruskal‐Wallis and Wilcoxon signed‐rank tests in SPSS. Qualitative feedback was examined through thematic content analysis. Results: Of 33 responses analysed, 69% of participants lacked prior knowledge or experience, yet the median likelihood to recommend the technology was “somewhat likely”. A significant preference emerged for supporting patients in the acute post‐treatment phase (p = 0.008). Thematic analysis identified key benefits of enhanced patient‐practitioner communication and patient empowerment through symptom monitoring, while primary barriers were increased workload and patient digital literacy. Conclusion: Australian radiation therapists, despite limited hands‐on experience, view mHealth applications as a positive addition to radiation oncology care, especially during the acute post‐treatment phase. Successful implementation hinges on inclusive design and comprehensive training to mitigate workload and literacy barriers, ensuring effective supplementation of face‐to‐face interactions and improved care continuity. References 1. Kessel KA, Vogel ME, Schmidt‐Graf F, Combs SE. Mobile apps in oncology: a survey on health care professionals’ attitude toward telemedicine, mHealth, and oncological apps. Journal of Medical Internet Research 2016;18(11):e312–2. 2. Hernandez Silva E, Lawler S, Langbecker D. The effectiveness of mHealth for self‐management in improving pain, psychological distress, fatigue, and sleep in cancer survivors: a systematic review. J Cancer Surviv 2019;13(1):97–107. 3. Janssen S, El Shafie RA, Ruder AM, et al. Mobile applications in radiation oncology‐current choices and future potentials. Strahlentherapie und Onkologie 2023;199(4):337–49. Little patients, big feelings: Using play therapy in RT departments to improve paediatric patient experiences Georgia Bria 1 , Charlotte Hurt 1 , Austin Lorenz 1 , Nha Linh Nguyen 1 1 The University of South Australia, Adelaide, Australia Childhood cancer remains the second most common cause of mortality in children, with radiation therapy forming a critical component of treatment. 1 Paediatric patients face unique challenges throughout radiation therapy due to the intimidating adult‐centred hospital environment, unfamiliar equipment and the requirement to remain still throughout treatment. Consequently, patients can have high levels of stress and anxiety, frequently resulting in non‐compliance and reliance on sedation and general anaesthesia, introducing risks of medical complications and long‐term neurodevelopmental effects. 2 This presentation explores the roles of supportive therapeutic play strategies to create a more child‐centred radiation therapy environment and reduce the impact of challenges paediatric patients face. Current approaches involve recreational strategies such as decorating paediatric patients’ immobilisation masks or art therapy, and audiovisual distraction methods such as immersive virtual reality. 3 Radiation therapy departments can tailor these strategies to meet the needs and complement the behaviours of paediatric patients, increasing patient experience, reducing anxiety and improving treatment compliance. 2 Evidence indicates the importance of providing a multi‐disciplinary approach involving radiation therapists, nurses, oncologists and allied health professionals to realistically and effectively implement these strategies into protocols and current practice. 1‐3 References 1. Nazari AM, Sarmadi S, Ghazanfari MJ, et al. The effectiveness of play therapy on depression and anxiety in hospitalized children with cancer: a systematic review. Supportive Care Cancer 2025;33(2). https://doi.org/10.1007/s00520‐024‐09144‐4 2. O'Connor M, Halkett GKB. Supporting paediatric patients to receive radiation therapy without sedation or general anaesthetic. JAMA 2023;70(4):357–9. https://doi.org/10.1002/jmrs.734 3. Holt DE, Hiniker SM, Kalapurakal JA, et al. Improving the pediatric patient experience during radiation therapy‐a children's oncology group study. Int J Radiat Oncol Biol Phys 2021;109(2):505–14. https://doi.org/10.1016/j.ijrobp.2020.09.002 Sunday 29 March, 9:30 AM – 11:00 AM Cultural Considerations Navigating MRI safety and informed consent for First Nations people in Central Australia Danielle Dew 1,2 , Christen Barras 1,2 , Gabrielle Fry 4 , Emma Smith 3 , Donna Lemon 1 , Christine Spencer 1 1 Alice Springs Hospital, Alice Springs, Australia, 2 Jones Radiology, Adelaide, Australia, 3 Lemon Tree Media and Productions, Alice Springs, Australia, 4 Coolamon Creative, Alice Springs, Australia Introduction: Approximately 70% of patients seeking health care in the Northern Territory are First Nations people. 1 However, there is no formal MRI safety and procedural information available in Indigenous languages. Improving MRI safety and procedural education for Indigenous Australians is urgently needed to promote patient‐centred care and assist in closing the gap. Methods: A baseline audit of MRI appointments was conducted for 2023, assessing cancellation rates and aborted scans. For the first time, MRI safety and procedural information were translated into the Indigenous language Warlpiri and produced as a professional audio‐visual presentation, narrated by a native speaker. The audio‐visual's effectiveness will be evaluated using MRI resource utilisation statistics. Results: In 2023, First Nations people accounted for 36% of all scheduled MRI appointments. However, Indigenous patients represented 62.5% of brain scans that were not attempted and 86.5% of aborted or truncated scans. Notes often indicated that the patient was scared or did not understand the procedure or its relevance. The audio‐visual presentation will be demonstrated, and pilot results on its impact on MRI cancellations and incomplete studies will be shared. Conclusion: Translating MRI safety and procedural information into the native language of First Nations people is a valuable improvement to clinical care, with direct effects on patient safety and resource use. Once validated, this initiative could be expanded to many other Indigenous languages and adapted for use in additional modalities within medical imaging. Reference 1. Northern Territory Government. 2016. Aboriginal and Torres Strait Islander Health ‐ Department of Health [Internet]. Available at https://health.nt.gov.au/professionals/aboriginal‐and‐torres‐strait‐islander‐health Supportive care of Aboriginal and Torres Strait Islander peoples receiving radiation therapy in Australia Georgia Halkett 1 , Amy Brown 2 , Cathy Hargrave 3 , Julie Burbery 4 , Melissa Berg 1 , Purnima Sundaresan 5,6 , Haryana Dhillon 7 , Gail Garvey 8 1 Curtin University, Perth, Australia, 2 Townsville Cancer Centre, Townsville University Hospital, Townsville, Australia, 3 Princess Alexandra Hospital, Brisbane, Australia, 4 Queensland University of Technology, Brisbane, Australia, 5 Sydney West Radiation Oncology Network, Sydney, Australia, 6 Sydney Medical School, The University of Sydney, Sydney, Australia, 7 Psycho‐Oncology Cooperative Research Group, The University of Sydney, Camperdown, Australia, 8 The University of Queensland, Brisbane, Australia Introduction: Aboriginal and Torres Strait Islander peoples have poorer cancer outcomes with higher age‐standardised cancer incidence, poorer 5‐year survival and higher mortality rates compared with other Australians. 1 To date, there is limited evidence on how radiation therapists (RTs) support Aboriginal and/or Torres Strait Islander peoples during treatment. We aimed to determine RTs’ experience of supporting Aboriginal and/or Torres Strait Islander peoples receiving radiation therapy, including any cultural training received. Methods: Ethics approval was provided by both the statewide Aboriginal health and university ethics committees. RTs across Australia were invited to complete an online survey which included custom questions, a validated cultural awareness and capability instrument, 2 and items on clinical competencies. 3 Descriptive statistics were used. Results: Of 87 respondents, the majority (70%) provided care to an Aboriginal and/or Torres Strait Islander patient at least 1–2 times per month. Most RTs (81%) had access to an Aboriginal Health Worker and 48% stated most/all Indigenous patients were referred. Almost all RTs (99%) had completed some cultural training (86% mandatory training). Domain scores of the cultural awareness and capability instrument (Table 1), showed RTs’ lowest rated domain was confidence providing culturally safe care. Conclusions: Most RTs regularly provide treatment to Aboriginal and/or Torres Strait Islander patients and have received cultural training. However, RTs low confidence in providing culturally safe care indicates a need for improved training and greater involvement with Aboriginal and Torres Strait Islander communities and Aboriginal Health Workers. These results will be used to inform development of discipline‐specific cultural training. References 1. Australian Institute of Health and Welfare. 2018. Cancer in Aboriginal & Torres Strait Islander people of Australia. Available at https://www.aihw.gov.au/reports/cancer/cancer‐in‐indigenous‐australians/contents/summary 2. West M, Sadler S, Hawke F, Munteanu SE, Chuter V. Effect of a culturally safe student placement on students' understanding of, and confidence with, providing culturally safe podiatry care. J Foot Ankle Res 2021;14(1):9. 3. The Royal Australian and New Zealand College of Radiologists. Radiation Oncology Learning Outcomes, Version 2.0. Sydney, Australia: RANZCR; 2024. Listening to Aboriginal men about their radiation therapy stories in western New South Wales Rodney Hammond 1 1 Western NSW Local Health District, Australia Introduction: Indigenous Australians are 20% less likely to survive a cancer diagnosis than non‐indigenous Australians. 1 Research that simply describes this disparity is limited in its ability to address and close the survival gap. 2 A qualitative study was conducted to identify challenges faced by Aboriginal men accessing radiation therapy in Orange, New South Wales. The aim of this research was to improve local understanding of the needs of Aboriginal men in western NSW and to translate this knowledge into practice improvements that reduce barriers to accessing this vital cancer treatment. Methods: Six Aboriginal men who had received radiation therapy treatment were interviewed either via telephone or in‐person. Kapati, an Indigenous narrative enquiry technique that utilises storytelling and yarning, 3 was used to capture each participant's experience. Through collaborative analysis, common themes and ideas were linked and framed through the story of the project logo to best portray their cancer journey. Results: Despite positive accounts, the men shared insights into aspects that proved difficult and offered pragmatic solutions to improve treatment access. Family support, the need for dedicated Aboriginal Care Coordinators and the importance of education in ways that are culturally sensitive were emphasised. Conclusion: The study revealed the unique cancer journeys of participants and highlighted the need for personalised care. Listening to their stories gives Aboriginal men a voice in how radiation therapy is provided for their community. These insights will inform tailored interventions aimed at improving cancer outcomes for Indigenous Australians. References 1. Australian Institute of Health and Welfare. 2021. Cancer in Australia 2021. Cancer series no. 133. Cat. no. CAN 144. Available at https://www.aihw.gov.au/reports/cancer/cancer‐in‐australia‐2021/summary 2. Cunningham J, Rumbold AR, Zhang X, Condon JR. Incidence, aetiology, and outcomes of cancer in Indigenous peoples in Australia. Lancet Oncol 2008;9(6):585–95. https://doi.org/10.1016/S1470‐2045(08)70150‐5 . 3. Ober R. Kapati time: storytelling as a data collection method in indigenous research. Learning communities. International Journal of Learning in Social Contexts 2017;22:8–15. https://doi.org/10.18793/LCJ2017.22.02 Professional education in low‐ to middle‐income countries: The IOMP school on IMRT Lisa Cunningham 1 , Janatul M Wahabi 2 , Arun Chougule 3,4 , Eva Bezak 1,4 1 Adelaide University, Adelaide, Australia, 2 National Cancer Institute, Putrajaya, Malaysia, 3 Swasthya Kalyan Group, Jaipur, India, 4 International Organization for Medical Physics, York, United Kingdom Introduction: The International Organization for Medical Physics (IOMP) hosted an inaugural school on intensity modulated radiation therapy (IMRT) in October 2024. Located at the National Cancer Institute (NCI) in Putrajaya Malaysia, the school was aimed at medical physicists from low‐ to middle‐income countries. The objectives of the school were to improve medical physicists understanding of IMRT, including treatment planning, delivery and quality assurance (QA). Prior to the school, participants were asked to perform pre‐reading of 12 online lectures from the ICTP school on medical physics for radiation therapy. Held over 4 days, sessions included lectures delivered by content experts, dosimetry workshops using the Eclipse Treatment Planning System (courtesy partnership with Varian Medical Systems, Inc.), and patient‐specific QA practicals held on a linear accelerator at NCI. Following the event, online Zoom sessions were scheduled for participants to reconnect with lecturers, ask questions and explore more complex techniques. Results: 29 participants attended the school from seven different countries. Feedback from participants obtained after the school via an online survey was positive (Fig. 1). In free text responses regarding which aspects of the course they found most useful, participants highlighted hands‐on planning sessions (n = 12), patient‐specific QA sessions (n = 3), lectures (n = 6), and networking opportunities (n = 4). Conclusion: The IOMP school on IMRT was a successful initiative that enhanced access to high‐quality education and practical training for radiotherapy professionals in low‐ to middle‐income countries. Plans to expand similar training opportunities across regions will continue to build capacity and equity within the global radiation therapist community. Radiation therapy student collaborative online international learning: Co‐designing global learning for tomorrow's radiation therapists Kylie Auld 1 , Caroline Wright 1 1 Monash University, Melbourne, Australia Introduction: As radiation oncology becomes increasingly globalised, the importance of international collaboration in enhancing training of medical professionals by exposing students to diverse healthcare practices, fostering cultural competence and enabling the exchange of best practices across borders, is becoming critical. 1,2 Collaborative learning between institutions from different countries encourages the development of critical thinking and problem‐solving skills as students navigate various healthcare standards and protocols. 3 Objectives: The Radiation Therapy Student Collaborative Online International Learning (RTSCOIL) project explores how virtual global partnerships can enrich radiation therapy student learning. RTSCOIL addresses the growing need for innovative, equitable and inclusive education in medical radiation sciences. RTSCOIL provides international learning opportunities without the need for costly and time‐consuming travel. Co‐designed by educators and students from Australia, Hong Kong and Singapore, RTSCOIL connects students globally to collaborate on real‐world clinical challenges, share cultural perspectives and build professional skills. Through a structured online program, students work in small international teams to solve radiotherapy challenges, conduct peer reviews and reflect on their learning. Discussion: While traditional online learning often lacks interaction and global context, RTSCOIL addresses this by blending technical training with peer‐to‐peer collaboration. Students participate in co‐design, case studies, small group activities and presentations. The program utilises a mix of live Zoom sessions, a shared learning platform, surveys and discussion forums to support flexible interactive learning. This presentation will discuss the development of RTSCOIL, initiated by educators to boost engagement, foster intercultural understanding, and prepare students for diverse healthcare environments. References 1. Frenk J, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet 2010;376(9756):1923–58. 2. Golafshani A, Siamian H. Internationalizing the transformation and innovation approach in health higher education. Future of Medical Education Journal 2021;11(2):47–52. 3. Brown D, Ma S, Mason C. Intercultural communication competence and short‐term study abroad: a study of medical students. IJIR 2018;66:123–35. Sunday 29 March, 9:30 AM – 11:00 AM Navigating Research Building the bridge between potential and performance: Research mentoring Elizabeth Brown 1 , Michael Neep 2 , Rachael Beldham‐Collins 3 1 Princess Alexandra Hospital, Brisbane, Australia, 2 Logan Hospital, Meadowbrook, Australia, 3 Western NSW Local Health District, Australia Mentoring promotes a continual process of growth, helping develop an individual's potential into meaningful achievements. This is particularly true for research development. Evidence suggests that research mentoring can increase the capacity and quality of medical radiation professionals (MRPs) involved in research. 1,2 The process continues seeing mentees become mentors, inspiring and assisting others to become involved in research. A research demographics survey of Australian MRPs conducted in 2020 found that research mentoring was one of the top two desired support mechanisms required to facilitate future research participation. 3 One of the recommendations of this survey was to establish support mechanisms for research mentoring to aid in research capacity building in the profession. 3 To assist with addressing this important issue, the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT) is establishing a research mentor program to link experienced and less experienced MRP researchers. The overarching objective of the program is to increase the capacity and quality of Australian MRPs involved in research and foster personal and career development. The program will be based on the highly successful FoRRM (Formal Radiography Research Mentoring) scheme run by the College of Radiography in the United Kingdom. The purpose of this presentation is to introduce the ASMIRT Research Mentoring Program, outlining what the program entails and providing information on how people can become involved. We look forward to people starting this journey of discovery and realising their research potential. References 1. Borkowski D, McKinstry C, Cotchett M, Williams C, Haines T. Research culture in allied health: a systematic review. Aust J Pim Health 2016;22:294–303. 2. Dennett AM, Cauchi T, Harding KE, et al. Research interest, experience and confidence of allied health professionals working in medical imaging: a cross‐sectional survey. J Med Radiat Sci 2021;68:121–30. 3. Chau M, Brown E, Beldham‐Collins R, Anderson N. Research demographics of Australian medical radiation practitioners. J Med Imag Radiat Sci 2022;53(4):591–8. Reflections on the ASMIRT 2025 Dorothy Lorimer Bursary: Summer in Slovenia Laura Di Michele 1 1 The University of Sydney, Sydney, Australia OPTIMAX is an international collaborative summer research school for medical radiation science students and researchers. It has been running for over 10 years and is hosted by a different European nation each year. In July 2025, it was hosted by the University of Ljubljana in Slovenia, and as the recipient of the Australian Society of Medical Imaging and Radiation Therapy Dorothy Lorimer Bursary I was able to attend the school. During this experience I was fortunate to work with the organising committee to listen and learn more about the program and its administration, as well as take part in the program as an academic tutor. The primary objective of OPTIMAX is to develop basic research skills in students and new professionals, however it's so much more than that. It develops teamwork, critical thinking and leadership skills, all while fostering international collaborative networks, both among the participants and the academic community. In this presentation I will share my reflections and learnings from the experience, touching on some of the research that was undertaken at the school. I will then discuss the OPTIMAX model and how it could be adapted into a local context to develop a similar school for our region, creating a network and a pipeline for future researchers in Australia. Listening to the landscape: Navigating research strategy development in medical radiation practice Amy Hancock 1 , Martine Mallinson 2 , Daniel Hutton 3 1 The University of Exeter, Exeter, United Kingdom, 2 Mid Yorkshire Teaching NHS Trust, Wakefield, United Kingdom, 3 North West Radiotherapy Specialised Services Clinical Network, United Kingdom Introduction: As the medical radiation profession seeks to navigate the challenges and opportunities posed by new service‐delivery models and technologies, there is a requirement to strengthen the discipline‐specific evidence base through knowledge generation. 1 Increasing research‐based practice and capacity has been a strategic priority for the United Kingdom Society and College of Radiographers (SCoR). 2 The implementation of a research strategy is seen to strengthen research culture, build capacity and facilitate the workforce's ability to actively participate and innovate. 3 Methods: In collaboration with SCoR, the authors utilised a survey to benchmark the number of UK medical radiation departments that had developed their own discipline‐specific research strategy. The project also explored what systems had been employed to facilitate their development, and to understand any enablers aiding their development alongside any barriers. Results: The survey established how many UK departments lacked a formal research strategy or systems to support professionals to navigate or engage in their development. While strategy numbers were low, the survey discovered the desire to engage in research strategy development activity was high. The authors identified a range of practices that respondents felt could help and support them to increase strategy engagement and capacity. Conclusion: By listening to the workforce, the authors have been able to understand the current climate and have developed models of support that medical radiation departments and professionals can access to create and enhance future research strategy. This presentation will share learning and outline the practices employed across the UK to help build sustainable research cultures. References 1. Malamateniou C. Radiography and research: a United Kingdom perspective. Eur J Radiograp 2009;1(1):2e6. 2. The College of Radiographers. Research strategy 2021‐2016. London: The College of Radiographers; 2021. 3. Gee M, Cooke J. How do NHS organisations plan research capacity development? Strategies, strengths, and opportunities for improvement. BMC Health Serv Res 2018;18(198). Barriers to radiography research engagement and capacity: A mixed methods study of Australian students and qualified radiographers Hudson Hyde 1 1 Monash University, Melbourne, Australia Introduction: Research enhances professional practice, departmental efficiency and patient outcomes, yet radiographer research participation remains low. 1‐3 Reviewing the literature (2010–2024) identified 11 studies investigating radiographer research barriers; only two were Australian, neither included private sector radiographers or students. 1,2,4‐11,13 This study aimed to identify research capacity, barriers, motivators and perceptions of research culture among Australian radiographers and students to inform engagement enhancing strategies. Methods: The prospective mixed methods design combined quantitative data from the validated Research Capacity and Culture tool with qualitative focus group interviews. The Research Capacity and Culture survey, promoted by the Australian Society of Medical Imaging and Radiation Therapy and LinkedIn, was accessible through Qualtrics and analysed using descriptive‐statistics and Mann‐Whitney U tests. Convenience sampling recruited participants for six online focus groups (two radiographer, four student), exploring perceptions, motivators and barriers, with member checking for validity. Results: 78 radiographers met the survey inclusion criteria; 85% reported <10% research involvement. Individual research capacity was low (mean = 3.75) and workplace capacity moderate (mean = 5.17); public sector scored higher than private in the workplace domain (p = 0.01). Major barriers included competing work priorities (74%), limited time (72%), and desire for work‐life balance (63%). Motivators included skill development (56%), problem solving (47%), and improving patient outcomes (45%). Focus groups (n = 42, 35 students, seven radiographers) revealed site‐specific, medically driven research cultures, limited literature access in private practice, and burnout. Students reported limited research incentives and discouragement from education and clinical sites. Conclusion: Research engagement remains low, with capacity comparable to other allied health fields. 11‐13 Barriers emerge during university and persist into practice. Enhanced mentorship, protected research time and curriculum reform are critical to building research capacity and engagement across the profession. References 1. Al Balushi H, Watts H, Akudjedu TN. Research and evidence‐based practice in clinical radiography: a systematic review of barriers and recommendations for a new direction. Radiography 2024;30(2):538–59. https://doi.org/10.1016/j.radi.2024.01.012 2. Rawle M, Pighills A, Mendez D, Dobeli K. Radiographic technique modification and evidence‐based practice: a qualitative study. J Med Radiat Sci 2023;70(1):56–63. https://doi.org/10.1002/jmrs.616 3. Saukko E, Andersson BT, Bolejko A, et al. Radiographers' involvement in research activities and opinions on radiography research: a Nordic survey. Radiography 2021;27(3):867–72. https://doi.org/10.1016/j.radi.2021.02.002 4. Chau M, Brown E, Beldham‐Collins R, Anderson N. Research demographics of Australian medical radiation practitioners. J Med Imaging Radiat Sci 2022;53(4):591–8. https://doi.org/10.1016/j.jmir.2022.07.009 5. Bolejko A, Andersson B.T, Debess J, et al. Facilitators for and barriers to radiography research in public healthcare in Nordic countries. Radiography 2022;28(1):88–94. https://doi.org/10.1016/j.radi.2021.08.007 6. Ahonen SM, Liikanen E. Radiographers' preconditions for evidence‐based radiography. Radiography 2010;16(3):217–22. https://doi.org/10.1016/j.radi.2010.01.005 7. Garlock‐Heuer A, Clark KR. Medical imaging and radiation therapy professionals' perceptions of conducting research. Radiol Technol 2020;91(3):240–8. 8. Hancock A, Hutton D, Roberts D, et al. Barriers and facilitators to conducting radiotherapy clinical trials: findings from a UK survey. Radiography 2023;29(2):369–78. https://doi.org/10.1016/j.radi.2023.01.001 9. Abuzaid MM, Tamam N, Elshami W, et al. Exploring radiographers' engagement in research: motivation and barriers in five Arab countries. Healthcare 2023;11(20):2735. https://doi.org/10.3390/healthcare11202735 10. Ooi C, Lee SHE, Soh BP. A survey on the research awareness and readiness among radiographers in Singapore General Hospital (SGH). Radiography 2012;18(4):264–9. https://doi.org/10.1016/j.radi.2012.06.004 11. Janerka C, Leslie GD, Gallagher O, et al. Understanding research capacity and culture of nurses and midwives in two health services in Western Australia. Collegian 2024;31(3):137–43. https://doi.org/10.1016/j.colegn.2024.02.001 12. Cordrey T, King E, Pilkington E, Gore K, Gustafson O. Exploring research capacity and culture of allied health professionals: a mixed methods evaluation. BMC Health Serv Res 2022;22(1):85. https://doi.org/10.1186/s12913‐022‐07480‐x 13. Frakking T, Craswell A, Clayton A, Waugh J. Evaluation of research capacity and culture of health professionals working with women, children and families at an Australian public hospital: a cross sectional observational study. J Multidiscip Healthc 2021;14:2755–66. https://doi.org/10.2147/JMDH.S330647 Advancing research in medical radiation practice: The development of clinically informed questionnaires as tools for discovery Michael Neep 1 , Shayne Chau 2 1 Queensland University of Technology, Brisbane, Australia, 2 Charles Sturt University, Wagga Wagga, Australia Questionnaires are essential tools in medical radiation practice research, yet their development processes often lack consistency, methodological rigor and validation. This inconsistency undermines the reliability of the data collected, potentially leading to misleading conclusions, inappropriate clinical decisions and unnecessary costs. 1 When not carefully designed, questionnaires may inadvertently misrepresent clinical realities, potentially leading to less accurate insights and unintended impacts on practice. 2 To address these critical issues, this presentation introduces a structured five‐step framework for developing clinically informed, high‐quality questionnaires. Synthesising best practices from established survey design methodologies, this approach provides a clear, adaptable pathway for researchers at all levels. By systematically addressing each step, developers can enhance the validity and reliability of their instruments – ensuring they accurately measure what they are intended to. 3 Ultimately, this framework aims to elevate the standard of questionnaire design in medical radiation research, supporting more robust evidence generation and improved clinical outcomes. References 1. Artino Jr AR, La Rochelle JS, Dezee KJ, Gehlbach H. Developing questionnaires for educational research: AMEE Guide No. 87. Medical Teacher 2014;36(6):463–74. 2. Burns KE, Duffett M, Kho ME, et al. A guide for the design and conduct of self‐administered surveys of clinicians. CMAJ 2008;179(3):245–52. 3. Rattray J, Jones MC. Essential elements of questionnaire design and development. J Clin Nurse 2007;16(2):234–43. Sunday 29 March, 9:30 AM – 11:00 AM Advanced Practice Pressure, complexity and responsibility: Exploring human factors in advanced practice Leigh Ambrose 1,2 , Shaun Sae‐Lieo 1 , John Atyeo 1,2,3 1 Northern Sydney Cancer Centre, Sydney, Australia, 2 Monash University, Melbourne, Australia, 3 The University of Sydney, Sydney, Australia Introduction: This presentation aims to explore whether complex and recurring decision‐making in advanced practice radiation therapy leads to fatigue and stress among practitioners. Specifically, it investigates how human factors, particularly those identified within human factors and ergonomics in health care models, may contribute to cognitive load and decision fatigue in online adaptive radiation therapy. 1 Key Findings: Advanced practice in adaptive radiation therapy extends the scope of practice for radiation therapists, necessitating time‐sensitive decisions during treatment delivery and planning. These decisions are influenced by patient factors, such as anatomical changes and comfort, which contribute to cognitive load. Key stressors include time pressure, clinical complexity and patient variability, creating a kind of professional wilderness where practitioners must balance precision, efficiency and compassion. Evidence suggests that such factors can increase practitioner fatigue and affect decision‐making quality and lead to decision fatigue. 2 Conclusions: The cognitive load associated with advanced practice can contribute to fatigue, stress and reduced the wellbeing of radiation therapists. These factors, in turn, may affect practitioner performance and safety and quality of care. Understanding and addressing human factors is crucial to improving both practitioner wellbeing and patient outcomes. Implications for Practice: It is essential for leaders in radiation therapy to recognise and mitigate human factors that impact advanced practitioners. Implementing operational strategies that reduce cognitive load and stress, can help support safety and quality of care. This session encourages reflection on wellbeing and suggests practical strategies for minimising the negative effects of human factors in adaptive radiation therapy. References 1. Carayon P, Kleinschmidt P, Hose BZ, Salwei M. Human factors and ergonomics in health care and patient safety from the perspective of medical residents. Textbook of Patient Safety and Clinical Risk Management 2021;81–9. https://doi.org/10.1007/978‐3‐030‐59403‐9 2. Stec N, Arje D, Moody AR, Krupinski EA, Tyrrell PN. A systematic review of fatigue in radiology: is it a problem? Am J Roentgenol 2018;210(4):799–806. https://doi.org/10.2214/AJR.17.18613 Shaping advancing practice radiography in the UK: Policy, practice and professional progress Charlotte Beardmore 1 1 Society and College of Radiographers, London, United Kingdom In the early 2000s the United Kingdom government advocated for the implementation of assistant practitioners in imaging working under supervision of the registered radiographer, within a narrow defined scope of practice, to support safe delivery of expanding services due to growing demand. 1 The UK Society of Radiographers negotiated for a four tier career progression pilot to be funded advocating for the implementation of advanced and consultant practice alongside an assistant practitioner role; a new career progression model was implemented. The Society and College of Radiographers has continued to support the radiography profession in advancing practice in line with service need, with appropriate underpinning masters and doctoral level education, and in line with regulatory requirements. In 2017, national government‐led work in England continued to drive policy to ensure that the multi‐professional (non‐medical) workforce could be supported and developed, through post‐registration master's level education and training to transform care for patients, delivering innovation and optimising care for patients, often in new settings and across patient pathways. 2 This policy has led to the establishment of national frameworks across the UK with a Centre for Advanced Practice established to support delivery at pace and scale in England. 3 This presentation will showcase the current developments in the UK in relation to advancing practice, including how the Society of Radiographers as the professional body is supporting members using the education and career framework. 4 References 1. Department of Health. Radiography skills mix: a report on the development and implementation of skill mix in radiography services [Internet]. Available at https://www.radiographyonline.com/article/S1078‐8174%2824%2900204‐9/fulltext 2. Health Education England. 2017. Multi‐professional framework for advanced clinical practice in England [Internet]. Available at https://www.hee.nhs.uk/our‐work/advanced‐practice/multi‐professional‐framework 3. NHSE Centre for Advancing Practice [Internet]. Available at https://www.hee.nhs.uk/our‐work/centre‐advancing‐practice 4. Society and College of Radiographers. Education and career framework for the radiography workforce. Fourth edn [Internet]. London: SoR; 2025. Building an advanced practice radiation therapy program: A framework for clinical leaders and practitioners Rebecca Height 1 , Kristie Matthews 2 , Nilgun Touma 1 1 Peter MacCallum Cancer Centre, Melbourne, Australia, 2 Monash University, Melbourne, Australia Developing an advanced practice radiation therapy (APRT) model of care requires a structured framework integrating clinical excellence, academic rigor and organisational support. 1 Building on the establishment of an APRT Fellowship Program in 2023, this work outlines the methodology for designing and implementing a structured program within a tertiary radiation oncology centre. The APRT Fellowship develops advanced clinical, technical and leadership competencies, aligned with service priorities and workforce needs. Program design employed an evidence‐informed, data‐driven framework incorporating multi‐disciplinary stakeholder consultation, governance design, competency mapping and outcome evaluation. This 2‐year program combines supervised clinical immersion, research and development and postgraduate studies, consistent with the Australian Society of Medical Imaging and Radiation Therapy's Pathway to Advanced Practice. 2 Fellows progress from clinical extension to autonomous practice through defined capability stages. Implementation requires clear role delineation, credentialing pathways and evaluation metrics linked to efficiency, quality and patient experience. Outcomes from the inaugural cohort demonstrated improved workflow efficiencies, increased delegation and enhanced continuity of care. Establishing an APRT model of care advances professional practice and creates a pipeline of expert clinicians equipped to lead innovation and support evolving models of patient‐centred care. National replication of structured advanced practice programs is essential to strengthen workforce capability, enhance professional identity and drive sustainable improvements in patient care. References 1. Matthews K, Duchesne G. Overcoming uncertainty: a framework to guide the implementation of Australian radiation therapy advanced practitioners. J Med Radiat Sci 2023;70(4):406–16. 2. Australian Society of Medical Imaging and Radiation Therapy. 2014. Pathway to advanced practice radiation therapy. Available at asmirt.org Establishing national radiation therapy advanced practitioner capability statements: A Delphi study Grace Holt 1,2 , Kristie Matthews 1,2 , Caroline Wright 1,2 1 Monash University, Melbourne, Australia, 2 Peter MacCallum Cancer Centre, Melbourne, Australia Introduction: Radiation therapy advanced practitioners (RTAPs) present the opportunity to enhance radiation therapy service delivery in Australia. However, the absence of explicit RTAP expectations has contributed to implementation uncertainty, limiting workforce development and mobility. 1 This study employed a scoping review and Delphi consensus approach to develop national RTAP capability statements to support advanced practice implementation. Methods: This ethics‐approved project followed a two‐stage design. Stage 1 was an international scoping review to identify and synthesise international allied health and nursing advanced practice frameworks. These data informed draft RTAP capability statements. Stage 2 was a three‐round modified Delphi survey engaging a multi‐disciplinary radiation oncology panel to refine and endorse the draft RTAP capability statements, with consensus defined as ≥80% agreement. Results: The scoping review provided the foundation for draft RTAP capabilities and confirmed the need for Delphi consensus given the lack of radiation therapy‐specific capability frameworks. Across professions, capabilities were often referenced but structured frameworks were uncommon, and clear terminology was mixed. The Delphi process is underway and expected to conclude by March 2026, incorporating iterative panel feedback to reach agreement on key RTAP dimensions, domains and capability statements. Conclusion: This study aims to deliver Australia's first nationally agreed RTAP capability statements, developed through systematic evidence synthesis and multi‐disciplinary consultation. This will provide a clear framework to guide RTAP implementation, credentialling and workforce mobility. This project was funded by the Victorian Medical Radiation Practitioners Education Trust. Reference 1. Matthews K, Duchesne G, Baird M. Navigating uncertainty: the implementation of Australian radiation therapy advanced practitioners. Tech Innov Patient Support Radiat Oncol 2021;17:82–8. https://doi.org/10.1016/j.tipsro.2020.12.002 Costing analysis of an advanced practice palliative radiation therapy role Scott Jones 1 , Mary Job 1 , Tahira Peer 1 , Tessa Peterson 1 , Natalia Mitina 1 , Luke Nicholls 1 , Tanya Holt 1 , Ruth Pethybridge 1 1 Radiation Oncology Princess Alexandra Hospital, Brisbane, Australia Introduction: The palliative advanced practice radiation therapist (APRT) role has a proven record of improving clinical workflow and reducing patient waiting times. 1,2 However, no evidence currently exists on the additional economic value posed by such roles. In this study we describe an investigation of cost impact for patients treated through the APRT care path at Radiation Oncology Princess Alexandra Hospital Raymond Terrace (ROPART). Methods: A mixed methods approach was used to collect and analyse cost data. A time‐and‐motion evaluation collected data on specific task duration based on a previously developed care path diagram. Combining the time data with personnel allocation from the care path diagram enabled a time‐driven, activity‐based costing method for calculating the overall care path costs. Additionally, an estimate of the cost to patients to attend care was collected through patient surveys. Outcomes were compared and summarised using descriptive statistics. Results: A comparison of the APRT care path to the non‐APRT care path showed a greater than 40% reduction in cost overall to deliver the same care. Cost differences varied across the points of care in alignment with APRT involvement. The cost impact of palliative patients attending treatment will be described using a summary of the survey outcomes. Conclusion: The comparison of the two care path options for palliative patients has demonstrated cost reductions with APRT role involvement at ROPART. This outcome will contribute to a body of evidence on the value proposition of APRT roles and demonstrates methods that could be employed for future APRT evaluations. References 1. Job M, Holt T, Bernard A. Reducing radiotherapy waiting times for palliative patients: the role of the advanced practice radiation therapist. J Med Radiat Sci 2017;64(4):274–80. https://doi.org/10.1002/jmrs.243 2. Job M, Holt T, Bernard A. An evaluation of an advanced practice role in palliative radiation therapy. J Med Radiat Sci 2019;66(2):96–102. https://doi.org/10.1002/jmrs.318 From learning to leading: Navigating the evolution of advanced practice in adaptive radiotherapy Alexandra Turk 1 , Maiko Crispin 1 , John Atyeo 1 , Brian Porter 1 , Shaun Sae‐Lieo 1 , Leigh Ambrose 1 1 Northern Sydney Cancer Centre, Sydney, Australia The 2019 commissioning of the Varian Ethos in our department highlighted the need for a sustainable radiation therapist (RT)‐led workflow to realise the full potential of online adaptive radiotherapy. Given the role's complexity and responsibility, an advanced practice framework was deemed essential for safe and effective implementation. In 2022, five RTs enrolled in a Master of Advanced Practice to formalise training and prepare for clinical responsibilities traditionally held by radiation oncologists. However, the anticipated smooth transition to an RT‐led workflow proved more complex than expected. Departmental credentialling was required prior to clinical implementation, involving online assessments of contouring and plan review. Despite several years of adaptive experience, some RTs felt underprepared for independent practice. The credentialling process was subsequently revised to strengthen confidence and competence. RTs collaborated to design an in‐house target contouring training program offering case‐specific feedback in a stress‐free, anonymous environment; reducing anxiety often associated with online workflows and observation by multiple multi‐disciplinary team members. Radiation oncologists provided ongoing mentorship, and a structured clinical mentoring meeting encouraged open discussion of adaptive patients, reinforcing learning and fostering interdisciplinary collaboration. Through this process of listening, adapting and discovery, RTs have gained the confidence essential for advanced practice. This progress has also supported program sustainability, with a further four RTs commencing their own advanced practice journey. Our experience highlights that the path to advanced practice is rarely linear, relying on collaboration, mentorship and iterative refinement to develop confident clinical leadership. Sunday 29 March, 9:30 AM – 11:00 AM Breast Imaging (MI) The art of deception – Withholding diagnosis in breast imaging Luke Barclay 1,2 , Rosie Turnbull 3 1 The University of Canberra, Bruce, Australia, 2 RMIT University, Melbourne, Australia, 3 Jones Radiology, Adelaide, Australia Introduction: Breast imaging mammographers and sonographers frequently acquire images revealing potential malignancies but are often prohibited from disclosing their observations to patients. This non‐disclosure practice raises ethical tension between professional boundaries, patient autonomy, and moral responsibility. 1 Limited research explores how these professionals feel about withholding potentially serious information. This study investigates the opinions and emotional experiences of breast imaging practitioners regarding nondisclosure of image findings. Methods: A qualitative descriptive design will be employed using semi‐structured focus group with mammographers and breast sonographers from Australian screening and diagnostic centres. Participants (≥2 years’ experience) were invited to take part to capture diverse perspectives. Interviews will explore attitudes toward disclosure, institutional norms, perceived risks, emotional impact and views on patient rights. Data was audio‐recorded, transcribed and thematically analysed following Braun and Clarke's six‐phase framework. 2 Results: Themes that are discussed include: 1) professional role boundaries; 2) fear of causing patient distress; 3) medico‐legal risk; 4) moral unease; and 5) institutional constraints. Sonographers may express greater disclosure comfort due to real‐time imaging interaction. Conclusion: This study provides an insight into how breast imaging professionals reconcile ethical, emotional and institutional pressures when withholding observations. Findings inform clearer communication frameworks and professional guidelines that balance empathy, ethics and role delineation. References 1. Pruski M, Rodger D, Hurford JE. Disclosing the undisclosed: are radiographers required to communicate a provisional diagnosis? J Med Ethics 2025;51(3):182–7. 2. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006;3(2):77–101. Breast ultrasound: Basics and beyond Andrew Grant 1 1 I‐MED, East Melbourne, Australia Breast ultrasound is a cornerstone imaging modality in the evaluation of breast pathology, complementing mammography and MRI. This presentation provides a comprehensive overview of fundamental scanning techniques, normal breast anatomy and the sonographic features of common benign and malignant lesions. Emphasis will be placed on optimising image quality, lesion characterisation using the BI‐RADS lexicon, and differentiating cystic from solid masses. Advanced topics will explore the breast elastography and MRI correlation. Through illustrative case examples, this session aims to enhance diagnostic confidence and underscore the pivotal role of breast ultrasound within the multi‐disciplinary diagnostic team. Breast implants – A fascinating history and the evolution of best image positioning Barbara Mandelson 1 1 BreastScreen NSW, Wollongong, Australia Introduction: From 19 th century paraffin injections to modern silicone and saline prostheses, breast implant innovation has transformed both reconstructive surgery and imaging practice. Radiographers now face unique challenges in balancing diagnostic accuracy with patient safety. This presentation reviews the historical development of breast implants and examines how evolving materials and surgical methods have shaped mammographic positioning techniques. Discussion: Key milestones – from Gersuny's early paraffin procedures to the Gerow‐Cronin silicone implant – are explored alongside complications such as paraffinomas, silicone granulomas and capsular contracture. Imaging examples from 2014–2025 highlight advancements in the Eklund (‘pushback’) technique and the refinement of implant‐displaced views. Current evidence shows MLOID views can detect up to 35% of cancers not seen on standard mediolateral oblique views, particularly in dense breasts. 1 These findings emphasise the importance of evidence‐based positioning protocols in screening clients with implants. Conclusion: Implementing consistent imaging methods enhances tissue visualisation, supports ALARA principles and increases diagnostic confidence. Ongoing review of implant imaging standards is vital for optimising outcomes for both clients and radiographers. Reference 1. Park J, et al. Appropriate screening mammography method for patients with breast implants. Sci Rep 2023;13(1):28399. https://doi.org/10.1038/s41598‐023‐28399‐1 Addressing workforce challenges in the evolving role of the mammographer Natalie Smith 1 1 Princess Alexandra Hospital, Brisbane, Australia Introduction: The mammography workforce faces significant challenges, including staff shortages, high turnover and limited access to training. 1 These issues are compounded by the emotional and technical demands of the job, as well as rapid technological advancements such as digital breast tomosynthesis and contrast‐enhanced mammography, which require continuous skill development. 2 As the scope of the mammographer's role grows, there is an increasing need for targeted training programs and retention strategies to support the profession's future. Method: An integrative literature review was conducted to explore the evolving role of the mammographer and examines how changes in technology, patient care and job responsibilities impact workforce sustainability. Results: Key findings highlight that the mammographer's role has expanded, requiring a combination of technical proficiency, emotional intelligence and patient‐centred care. However, challenges remain, including an aging workforce, limited access to training 3 and burnout due to increased workload and emotional strain. 2 Technological pressures also necessitate ongoing education to keep up with new advancements. 1 Discussion: To ensure the sustainability of the mammography workforce it is essential to expand training opportunities. Implementing retention strategies such as mentorship, financial incentives and flexible work arrangements can help reduce burnout and improve job satisfaction. 2 Continuous professional development platforms that address both technical skills and patient care are critical to supporting the evolving scope of the mammographer's role. 3 Listening to the needs of the workforce, both emotional and professional, is key to fostering a resilient and skilled team. 4 References 1. Janssen ME, Lee P, Wright K. Workforce shortages in mammography: addressing the challenges. Journal of Radiology Workforce 2022;45(3):123–32. 2. Liu A, Turner S, Kim J. The impact of burnout in the mammography profession: a review of current strategies. J Med Imaging 2023;28(2):45–58. 3. Smith TP, Anderson K, Gonzalez P. Access to mammography training in underserved areas. J Radiol Educ 2020;18(1):22–9. 4. Miller RL, Davis SP. Policy recommendations for a sustainable mammography workforce. Health Policy Review 2022;37(4):233–45. Sunday 29 March, 9:30 AM – 11:00 AM Navigating Clinical Learning (MI) Challenging interpersonal interactions in medical radiation science clinical education and strategies to improve placement outcomes Jacob Leonard Ago 1 , Andrew Kilgour 1 , Clare Smith 1 1 RMIT University, Melbourne, Australia Introduction: Clinical placement (CP) provides students with opportunities to apply theoretical knowledge in real‐life clinical settings under the supervision of qualified practitioners acting as mentors, supervisors and assessors. However, CP exposes students to many challenging clinical interactions. 1,2 These interactions reduce students’ sense of belonging, confidence and safety, with an overarching negative effect on knowledge transfer, professional capability development and wellbeing. This study examines some challenging interpersonal interactions (CIIs) in medical radiation science CP and strategies to support students. Methods: A phenomenology‐grounded theory design was used to examine CIIs and underlying processes on these interactions. Participants included medical radiation science practitioners, academics and students recruited through purposive sampling followed by theoretical sampling. Data was collected through semi‐structured interviews and focus groups via Microsoft Teams. A combination of phenomenological and grounded theory analyses was used to develop experientially grounded thematic theories. Results: The study involved 46 participants, including 18 undergraduates, 13 academic staff and 15 clinical staff. Identified CIIs were insider‐outsider syndrome, variability in clinical supervision practices (disengaging and unsupportive supervisors vs student‐centred supervisor), and expectation mismatch. Students cope by setting boundaries and relating with (few) receptive staff. Support strategies to enhance CP outcomes include availability of a supervision model, psychological safety (e.g. communication, empowering students, creating a safe apace), and feedforward strategies (e.g. anticipatory guidance, interprofessional training, simulation‐based learning). Conclusion: The challenges and support strategies identified provide a roadmap for developing resilience in medical radiation science students through effective preparation and empowering them to speak up during and after CIIs. References 1. Girn R, Punch A, Jimenez YA. Diagnostic radiography students' perceptions of working in the clinical environment: a focus on emotional challenges. Radiography 2022;28(2):492–8. https://doi.org/10.1016/j.radi.2021.11.001 2. Ago JL, Kilgour A, Smith C. Understanding the current situation of challenging clinical interactions for medical radiation undergraduates: an integrative literature review. Radiography 2024;30(2):104–13. https://doi.org/10.1016/j.radi.2024.10.027 An intervention for undergraduate radiography students' professional skill development prior to/during their first clinical placement Renee French 1 1 RMIT University, Bundoora, Australia Introduction: The combination of learning theory and practical applications are integrated into undergraduate radiography curricula by presenting scenarios and physical simulations of challenges encountered in clinical practice 1 to promote problem solving, critical thinking, 2,3 and reflective practice. This method of experiential learning can also be integrated to instil appropriate attributes and attitudes required by student radiographers for their professional career. 1 Methods: A pilot study was conducted to validate the pre‐ and mid‐placement preparedness surveys with second‐ and third‐year students. Participating first‐year students completed a pre‐placement and mid‐placement preparedness survey to highlight learning deficiencies to be covered during the intervention (mid‐placement online educational workshop) tailored to students’ learning needs. The effectiveness of the workshop was evaluated from student feedback and week 1 and week 3 clinical supervisor assessments. Results: After a successful pilot study conducted with 15 second‐ and four third‐year students (n = 19), first‐year students completed the pre‐placement questionnaire (n = 31), mid‐placement questionnaire (n = 30) and online educational workshop (n = 20). Students felt underprepared for modifying exposure factors, interacting with paediatric and geriatric patients, communication with ‘real patients’ and patient care in the clinical environment. These learning deficiencies were addressed during the educational intervention improving students’ knowledge and skills. Conclusion: The introduction of a mid‐placement interventional online education workshop was positively received by first‐year students. Student improvement was noted by supervisors and reflected in the formative and summative student clinical assessments. References 1. Sluming V. The changing world of radiography education. Br J Radiol 1996;69(822):489–90. https://doi.org/10.1259/0007‐1285‐69‐822‐489 2. Elshami W, Abuzaid MM, McConnell J, et al. The radiography students' perspective of the impact of COVID‐19 on education and training internationally: a across sectional survey of the UK devolved nations (UKDN) and the United Arab Emirates (UAE). Radiography 2022;28:S50–8. https://doi.org/10.1016/j.radi.2022.07.009 3. Pasquale SJ. Education and learning theory. In: Levine AI, DeMaria S, Schwartz AD, Sim AJ, editors. The comprehensive textbook of healthcare simulation. Springer; 2013:51–5. https://doi.org/10.1007/978‐1‐4614‐5993‐4_3 Beyond the scanner: Navigating the academic wilderness as a radiographer Mina Narouz 1 1 RMIT, Bundoora, Australia Aligned with the ASMIRT 2026 theme, ‘Navigate the Wilderness: Listen, Adapt, and Discover’, this presentation reflects on a personal and professional journey of embracing an unexpected academic role while continuing to practise clinically. Rather than being a departure from radiographic practice, academic involvement deepened my clinical reasoning, broadened my capacity to support students, and transformed how I engage with the profession. It began with a casual invitation to course coordinate at university – accepted while juggling full‐time clinical work. What started as a short‐term commitment evolved into a long‐term path of discovery. Teaching pushed me to listen deeply to students’ learning needs, adapt to new ways of communicating complex imaging concepts, and discover fresh perspectives on foundational principles. Research supports this professional synergy – clinicians who teach take on diverse, reinforcing roles, 1 and demonstrate improved clinical reasoning through student‐centred methods such as case‐based learning. 2 Alongside this professional growth came personal reflection. As a student, I received unwavering support during my mother's terminal illness. That experience shaped the kind of educator I aspire to be – present, compassionate and empowering. Today, I work within a supportive academic team committed to student success and professional collaboration. This presentation invites the audience to view academia not as a detour, but as a wilderness worth exploring – one that offers space to listen, adapt and discover who we can become as both educators and practitioners. References 1. Harden RM, Crosby JR. The good teacher is more than a lecturer: the twelve roles of the teacher. Med Teach 2000;22(4):334–47. https://doi.org/10.1080/014215900409429 2. Thistlethwaite JE, Davies D, Ekeocha S, et al. The effectiveness of case‐based learning in health professional education: a BEME systematic review. Med Teach 2012;34(6):e421–44. https://doi.org/10.3109/0142159X.2012.680939 Survival skills for the clinical frontier: Preparing students for hospital placements Susan Said 1 1 The University of Sydney, Sydney, Australia This presentation aims to report on the development of a quality improvement project conducted at a university in 2025. Clinical supervisors provided feedback through student assessments that students were underprepared for hospital placements particularly in work health and safety, adaptive technique and identifying and responding to urgent findings, and that students lacked confidence in these important skills. This innovation provided an opportunity to further develop students’ verbal communication skills and provide a safe environment for students to hone their practical skills in adaptive technique prior to clinical placement. It aimed to promote student confidence and capability in the acute healthcare setting. A co‐designed workshop was developed by collaborating with clinical supervisors in major metropolitan hospitals in Sydney to prepare students for hospital placements. Small groups of students (n = 10) will be guided through learning activities prior to hospital placements to ensure safety and competency in adaptive technique and identifying urgent findings. Developing a clinical competency framework for medical imaging staff to support ongoing professional skills Nicole Turley 1 , Kelly Fordyce 1 , Ashleigh Lyness 1 1 Logan Hospital, Meadowbrook, Australia Medical imaging departments are well versed in supporting student radiographers during clinical placements. Students are trained and assessed against set criteria, graduate and join our workforce meeting a set standard. However, after graduation how do we ensure that the clinical skills and professional expertise we develop throughout our career and within our services are maintained and retained? Medical imaging is a rapidly evolving field, with technology being upgraded often. Radiographers and sonographers often work across multiple modalities and technologies. How do we constantly adapt to these changes in an informed and supported manner? How does our department – whose aim is to provide a high‐quality imaging service – know our staff have the appropriate, current knowledge and capabilities? Logan Hospital Medical Imaging reflected on these questions and in response has developed a clinical competency framework for qualified radiographers and sonographers. It supports ongoing clinical practice and professional growth. It utilises a variety of assessment types (diagnostic, formative, summative) and adult learning principles to ensure knowledge and skill base is covered. It is designed to sit parallel to the health practitioner framework and is embedded within our departmental governance structures. We aim to share our journey so far and lessons learnt in developing and implementing the clinical competency framework into clinical practice, including the framework elements, supporting resources and governance model. This initiative represents a strategic approach to sustaining clinical excellence, nurturing a culture of continuous improvement and advancing professional practice in medical imaging. Wilderness observed: Is it time to accept the button‐pusher moniker? Adam Steward 1,2 , Jessica Watson 1 1 Western Health, Melbourne, Australia, 2 RMIT University, Melbourne, Australia Introduction: Following changes imposed by, and since, the COVID‐19 pandemic, medical imaging students engage in a mostly online learning environment, non‐compulsory lectures, and potential to have very limited engagement at university. Further, an increased demand for clinical placements has anecdotally seen clinical sites take on student placements and provide little teaching, supervision or emphasis on theoretical and/or clinical development. This propagates a lack of accountability for suitable theoretical and clinical knowledge, leading to potential theory‐gaps. This study sought to assess the reality of any theory gap and provide insight into the preparedness of students entering clinical placement. Methods: All students attending a single site medical imaging placement were offered the opportunity to complete a quiz to test their theoretical and clinical knowledge prior to the beginning of placement. The quiz consisted of 10 technical and 10 clinical radiographic questions of content covered in the first semester of first‐year medical imaging courses. Results were scored on a 0–2 scale to identify theory‐gaps, assessed as those where students scored zero. Results: Preliminary results demonstrate that seven of the 10 (70%) technical questions demonstrated a theory gap for more than 60% of students. Three of the 10 (30%) clinical‐based questions revealed theory‐gaps for the same percentage of students (n = 26). Conclusion: The study identified notable theory gaps in student knowledge and preparation for placement. Student knowledge of technical principles demonstrated a more remarkable lack of understanding than clinical knowledge. These results demonstrate concerning observations for the profession. Sunday 29 March, 11:30 AM – 1:00 PM Training in Practice (RT) Addressing inter‐observer variability in organs at risk contouring in radiation therapy education Crispen Chamunyonga 1 , Kerrie Mengersen 2 , Catriona Hargrave 1,3 1 School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia, 2 School of Mathematical Sciences, Queensland University of Technology, Brisbane, Australia, 3 Princess Alexandra Hospital, Brisbane, Australia Introduction: Artificial intelligence (AI) based contouring tools are increasingly used in radiation therapy. 1 Education is crucial in ensuring that students can accurately delineate and evaluate organs at risk (OAR). 2 This study investigated the variability in OAR contouring among undergraduate radiation therapy students and explored strategies to enhance the accuracy of contour assessments and feedback. Methods: A review of current contouring education was conducted, followed by an OAR contouring study across four tumour sites (brain, lung, parotid, prostate). Participants consisted of second‐ to fourth‐year students. Clinically validated OAR contours served as references to assess 348 contours both quantitatively, using the Dice Similarity Coefficient (DICE) and Hausdorff distances (HDmax, HD95 and HDavg) and qualitatively, through pass/fail ratings and a 4‐point Likert scale. Results: The bladder and lung showed the highest DICE values (>0.90) with less variability. The brainstem, heart and parotid scored moderately (0.76–0.87), while small structures such as the optic chiasm and lens showed lower DICE (<0.7) and greater variability. Contouring performance did not differ significantly between student cohorts (p > 0.05). The use of manual versus model‐based segmentation contouring differed significantly for DICE (p < 0.001) and HDmax (p = 0.0142). A comparison of quantitative and qualitative assessments reveals that contours with high qualitative scores generally also scored well in quantitative assessments. Conclusion: This study identifies OAR that students find most challenging to contour and areas that require further educational focus. A comparison of quantitative and qualitative ratings highlights an opportunity to enhance contouring training and feedback. References 1. Walker Z, Bartley G, Hague C, et al. Evaluating the effectiveness of deep learning contouring across multiple radiotherapy centres. Phys Imaging Radiat Oncol 2022;24:121–8. 2. Guidance on auto‐contouring in radiotherapy. 2024. The Royal College of Radiologists. Available at https://www.rcr.ac.uk/media/rqjlnlny/rcr‐auto‐contouring‐in‐radiotherapy‐2024.pdf Supporting the ‘transition to clinical practice’: Implementing a new radiation therapist graduate program Therese Chesson 1 , Alan Turner 1 1 Peter MacCallum Cancer Centre, Melbourne, Australia Transitioning from student to clinician radiation therapist can be challenging and stressful for some graduates. The need for graduate programs in the nursing workforce is well documented. 1 However, there is very little literature concerning graduate radiation therapists and associated radiation therapy programs. At our large teaching hospital with five radiation therapy campuses, we recognised the need for a radiation therapist graduate program to consolidate knowledge and skills in the growing junior workforce and the need to support theoretical knowledge and practical application of skills of new graduates. Graduates were initially surveyed to identify challenges in clinical practice and department collaboration sought to design a 12‐month program, delivered to newly employed graduates. The program that has been developed consists of a range of technical sessions with opportunity for peers to engage. Sessions focus on a range of techniques and technologies to ensure graduates are well supported as they undertake clinical practice and provided opportunity to foster their potential and promote person‐centred learning. There is also interprofessional collaboration aimed at enhancing wellbeing to enable clinicians to be equipped to provide holistic care to patients. Evaluation of the first cycle of the program was undertaken with post‐program participant surveys to determine feedback to improve the next cycle of the program. Results show graduates reported favourable levels of knowledge and confidence in their clinical practice. This presentation will outline the need to better support transition to clinical practice and share our experience developing a program to better meet the needs of new graduates. Reference 1. Hallaran AJ, Edge DS, Almost J, Tregunno D. New nurses' perceptions on transition to practice: a thematic analysis. Can J Nurs Res 2023;55:126–36. Student perspectives: Crossing waters to transition from student to qualification Corey Cleijne 1 1 RMIT University, Melbourne, Australia In Tasmania, almost 80% of healthcare graduates, including those in medicine, nursing, pharmacy, psychology, paramedicine and medical radiation science from the University of Tasmania choose to establish their principal place of practice within the state. 1 This highlights the importance local education plays in sustaining Tasmania's healthcare workforce. However, Tasmania experiences ongoing workforce shortages across multiple medical, nursing and allied health disciplines. The shortage is particularly significant in all medical radiation science professions. 2 Tasmania stands out as the only Australian state without a stand‐alone full medical radiation science course, presenting limited opportunities for students seeking to become medical radiation practitioners locally. This context creates both challenges and opportunities for those entering the profession in Tasmania. 3 This presentation reflects on the personal journey of a fourth‐year medical radiation science student transitioning from student to qualified radiotherapist during the first 3 months living and working in the state of Tasmania. This reflection aims to examine the realities of integrating into a new professional environment while facing unique state‐specific workforce experiences, radiotherapy training programs and adapting to local health service constraints. The reflective lens used considers personal, academic and wellbeing aspects of this transition, highlighting strategies for building resilience, social connection and professional confidence. The aim of this presentation is to encourage and inspire fellow students and graduates to embrace discomfort and uncertainty as important drivers of growth. By sharing challenges and triumphs, this presentation aims to offer practical insights for newcomers to Tasmania, showing how stepping outside familiar environments can foster personal and career development within health care. References 1. Jessup B, Tran N, Stevens T, Allen P, Barnett T. Towards a home‐grown rural health workforce: evidence from Tasmania, Australia. Aust J Rural Health 2024;32(5):976–86. 2. Jobs and Skills Australia. 2023. Occupation shortage list [Internet]. Available at https://www.jobsandskills.gov.au/data/occupation‐shortage/occupation‐shortage‐list 3. Inyang I, Barnett T, Obamiro K, et al. 'Growing your own' a case study of a collaborative training program in medical radiation science. J Med Radiat Sci 2023;70(4):398–405. Adaptable training, confident teams: Enhancing after‐hours radiotherapy care Rosanna Crain 1,2 1 Royal Adelaide Hospital, Adelaide, Australia, 2 Australian Bragg Centre for Proton Therapy & Research, Adelaide, Australia Providing after‐hours radiotherapy safely requires staff who are confident in managing urgent cases. With new staff demonstrating strong willingness to assume on‐call responsibilities and coinciding with the transition to a new treatment planning system, a dedicated team developed an independent training program to equip staff for this evolving role. The program is modular and self‐directed, allowing participants to progress at their own pace. Resources include video tutorials, resource links and a structured planning package. Designed for scalability, it accommodates multiple learners simultaneously and is accessible to staff with diverse experience, including those new to on‐call duties or treatment planning. Participants engage with broad troubleshooting scenarios which have been shown to foster adaptability and sound decision‐making in uncertain situations. 1 On completion, staff are credentialled as secondary on‐call practitioners and work alongside experienced colleagues until confident to assume primary on‐call responsibilities. By combining flexibility, accessibility and credentialling, the program supports staff development, enhances confidence 1 and strengthens preparedness for after‐hours service delivery. This presentation will outline the program's development, implementation, early outcomes and challenges faced. It will offer practical insights into how responsive, technology‐enabled training can build workforce staff capability and retention, 2 a learning culture, and empower staff to expand their skill set. References 1. Buljac‐Samardzic M, Doekhie KD, Van Wijngaarden JDH. Interventions to improve team effectiveness within health care: a systematic review of the past decade. Hum Resour Health 2020;18(1). 2. Mitosis KD, Lamnisos D, Talias MA. Talent management in healthcare: a systematic qualitative review. Sustainability 2021;13(8):4469. From classroom to virtual wilderness: Navigating CT simulation using virtual reality Lisa Cunningham 1 , Andrew Cunningham 2 1 School of Allied Health and Human Performance, Adelaide University, Adelaide, Australia, 2 School of Computer Science and Information Technology, Adelaide University, Adelaide, Australia Introduction: Virtual reality (VR) has long held a place in radiation therapy education, with the Virtual Environment for Radiotherapy Training (VERT) system providing a virtual linear accelerator since 2007 (Vertual Ltd, Hull UK). VR‐based learning has proven effective in bridging the theory‐practice gap for undergraduate radiation therapy students. 1 While several VR solutions exist for other radiation therapy technologies, including CT, these are often non‐immersive, limited by the cost of the hardware and software, and face accessibility challenges. 2 An in‐house immersive VR solution for CT simulation has been co‐designed and developed through a cross‐disciplinary collaboration with information technology students as part of an IT capstone project. Methods: Working alongside educators and students, the project team developed a prototype VR training tool aimed at improving student familiarity and confidence with the CT simulation process. The simulations allow for continuous, self‐paced training with randomised scenarios to enhance understanding of key CT concepts and workflow. Over a 15‐week development period, a concept demonstrator was produced and evaluated through end‐user feedback. Conclusion: The VR environment provides an authentic, interactive learning experience incorporating hand tracking to suit non‐technical users. A study plan has been established to integrate and evaluate this tool in an upcoming undergraduate course, with the goal of enhancing student preparedness for clinical CT simulation practice. References 1. Wijeysingha ES, Chin VYW, Lian CPL. Utilising virtual environments for radiation therapy teaching and learning. J Med Imaging Radiat Sci 2021;52(4 Suppl):S83–95. 2. Kok DL, Dushyanthen S, Peters G, et al. Virtual reality and augmented reality in radiation oncology education – a review and expert commentary. Tech Innov Patient Support Radiat Oncol 2022;24:25–31. Embedding clinical supervision in an Australian radiation therapy department: Practical strategies for sustainable implementation Rebekah Sizer 1,2 , Catherine Jager 1,2 , Nigel Anderson 1,2 1 Austin Health, Melbourne, Australia, 2 Olivia Newton‐John Cancer Wellness & Research Centre, Heidelberg, Australia Introduction: Clinical supervision (CS) provides effective, structured frameworks for allied health professional peer support. 1‐3 CS is increasingly adopted by radiation therapists (RTs) for its professional development, staff wellbeing and patient care benefits. 1 This quality improvement project explored the practical implementation of CS for RTs in Australia, identifying barriers and strategies to establish a sustainable and effective program. Methods: A voluntary CS program was introduced in our radiation therapy department for 24 RTs, divided into four groups. Monthly sessions were facilitated by trained experienced RTs, guiding discussions of workplace and clinical experiences in a confidential environment. The program was refined through staff consultation and leadership engagement, informing adjustments to scheduling, facilitation, and group composition to maintain engagement/effectiveness. Results: Key barriers identified in the consultation process included time constraints, clinical demands, and uncertainty of the purpose and relevance of CS in radiation therapy. Addressing these through protected time, consistent scheduling, emphasis of benefits and leadership support improved satisfaction and wider acceptance. With strong organisational support, the process demonstrated CS can be integrated into the department's routine alongside clinical workload. Conclusion: Embedding CS into busy radiotherapy departments requires commitment, education, structured planning and cultural change. By addressing practical and perceived barriers, CS has become a valued component of departmental professional culture, fostering a reflective and supportive environment. This initiative demonstrates how CS can be integrated into practice to strengthen professional development and wellbeing within the clinical workforce. Future CS expansion will look at collaborative opportunities with other allied health professionals. References 1. Dungey G, Neser H, Sim D. New Zealand radiation therapists' perceptions of peer group supervision as a tool to reduce burnout symptoms in the clinical setting. J Med Radiat Sci 2020;67(3):225–32. 2. Snowdon DA, Sargent M, Williams CM, et al. Effective clinical supervision of allied health professionals: a mixed methods study. BMC Health Serv Res 2020;20(2). 3. Sellers E, Craven‐Staines S, Vaughan C. Clinical supervision effectiveness in NHS nursing, medical and allied health professionals: exploring interaction with workplace factors, supervision factors and burnout. J Eval Clin Pract 2024;31(5). Sunday 29 March, 11:30 AM – 1:00 PM Inclusive Care Journeys Transgender and gender diverse patient experiences, care and health outcomes in medical imaging Kirralee Davies 1 , Ricky Lam 1 1 Gold Coast University Hospital, Gold Coast, Australia Introduction: Evolving legislation and shifting social attitudes towards transgender and gender diverse (TGD) individuals have raised clinical and ethical questions regarding their experiences, care and health outcomes in medical imaging. This scoping review aims to identify key themes surrounding TGD patient care in medical imaging. The research question guiding this review was: What are the current themes surrounding transgender and gender diverse patient experiences, care and health outcomes in medical imaging? Methods: A scoping search of the PubMed database was conducted for publications dated 2014–2024. Articles were included following full‐text screening based on relevance to the research question. Thematic analysis was performed using Braun and Clarke's approach to qualitative analysis. 1 Results: Of 118 publications identified, 28 met the inclusion criteria. Four major themes emerged: 1) training and education (n = 14); 2) the medical imaging department environment (n = 15); 3) diagnostic implications (n = 12); and 4) the lack of specific guidelines in literature (n = 11). Conclusion: TGD patient experiences in medical imaging are shaped by challenges in accurate sex and gender identification, limited training and education, non‐inclusive environments and the absence of modality‐specific guidelines. It is essential for radiographers, radiologists and imaging staff to understand the diagnostic impact of sex assigned at birth and to foster gender‐affirming practices. Medical imaging departments must invest in inclusive environments and accurate identification methods. Medical imaging disciplines should integrate TGD‐focussed curriculum and promote research to develop evidence‐based, modality‐specific guidelines informed by TGD patient data. Reference 1. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006;3(2):77–101. Listening to every voice: Navigating sensitive research through inclusive patient and public involvement and engagement Amy Hancock 1 , Christine Heales 1 , Carolyn Graham 2 , Fay Manning 1 1 University of Exeter, Exeter, United Kingdom, 2 Patient representative, United Kingdom Introduction: Weight stigma and bias in health care are well‐documented and can deter individuals from participating in research. These sensitivities often foster distrust, creating barriers to recruitment and engagement. 1 Patient and public involvement and engagement (PPIE) strategies allow us to listen to the patient voice, and are essential for building trust, enhancing transparency and fostering collaboration with underrepresented populations. 2 Methods: This presentation will detail two stages of the PPIE strategy for the Larger Bodies in Radiography project. Stage 1 welcomed contributions from four individuals with lived experience to develop a UK‐wide survey, inviting individuals to share their experiences of accessing radiographic services while living a larger body. Stage 2 invited 28 PPIE representatives, across five online focus groups designed to: explore participants’ perspectives on key priorities, including widening participation; co‐create belief statements to guide future PPIE activities; and collaboratively shape subsequent research phases. Results: Stage 2: PPIE consultation created the opportunity for the researchers to discover our target populations preferences, helping us to adapt and reshape the language and messaging across our recruitment. Stage 2: Across the focus groups, 22 PPIE participants shared their valuable insights, placing lived experience at the heart of the methodology. This included broadening inclusion criteria/recruitment location, greater exploration of language, discussion of cultural influences and use of different mediums/methods to capture data and support co‐design. Conclusion: Insights and action points from this collaborative approach have and will continue to shape future research development. By centring historically marginalised voices, PPIE enhances research inclusivity, relevance, credibility and impact. References 1. National Health Service. 2023. Increasing diversity in research participation: a good practice guide for engaging with underrepresented groups. 2. Morgan H, Thomson G, Crossland N, Dykes F, Hoddinott P, on behalf of the Bibs study team. Combining PPI with qualitative research to engage ‘harder‐to‐reach’ populations: service user groups as co‐applicants on a platform study for a trial. Res Involve Engage 2016;2(1). Community at the heart: Participatory and co‐production approaches in healthcare research Ben Potts 1,2 , Christina Malamateniou 1,2 , Themis Karaminis 1,2 , Emily Skelton 1,2 , Georgia Pavlopoulou 1,2 1 City St George's, University of London, London, United Kingdom 2 University Hospital Southampton, Southampton, United Kingdom Healthcare research has the greatest impact when it is relevant to the people it seeks to serve. Yet for many marginalised groups, including autistic and ADHD adults, research has too often been conducted about them rather than with them. Such studies often ask how neurodivergent differences affect healthcare systems or professionals, rather than how those systems affect neurodivergent people, or what it feels like to navigate environments built for the majority. Participatory, co‐produced and community‐based approaches seek to redress this by sharing power – enabling communities to shape priorities, influence methods and guide interpretation. In doing so, they ensure that lived experience drives every stage and that findings genuinely reflect the realities and needs of the community. The Neurodivergent patient Experience of Emergency Departments (NEEDs) Project applies these principles guided by a participatory action research approach and the A3ReAcH Framework for accessible and inclusive research. 1 A lived‐experience group of autistic, ADHD and AuDHD adults co‐leads each phase, from defining research priorities to shaping survey design and co‐authoring outputs. This presentation will share early lessons from this process – the ethical tensions, creative insights and transformative learning that arise when traditional hierarchies are replaced. By reflecting the political origins of participatory action research and presenting research as a collaborative and community‐led endeavour, this work highlights how radiography and healthcare research can push for more representative, equitable and impactful outcomes. Reference 1. Potts B, Skelton E, Pavlopoulou G, Karaminis T, Malamateniou C. The A3ReAcH (Autistic, ADHD and AuDHD research accessibility in healthcare) framework: principles for inclusive healthcare research with autistic, ADHD and AuDHD individuals in radiography and medical radiation technology. J Med Imaging Radiat Sci 2025;56(5):102009. Before the bore: Empowering patients and transforming anxiety in MRI through listening, adapting and empathy Emily Ross 1 1 Austin Health, Melbourne, Australia For many patients, MRI is more than a medical test – it's an emotional challenge that can trigger fear, claustrophobia or even panic. Yet these reactions are often hidden behind embarrassment or dismissed as inconvenient for staff. This presentation explores how radiographers can transform these moments of fear into trust by listening, adapting and rediscovering the power of empathy within routine MRI practice. Drawing on patient feedback surveys, current research and real‐world clinical experience, this work examines how small shifts in communication and approach can have a profound impact. When patients are offered transparency, choice and reassurance before entering the bore, they regain a sense of control. Anxiety – one of the most common barriers to scan success – can be eased through simple, evidence‐based strategies: clear communication, regular check‐ins, reassurance, and open discussion of options ranging from mild sedation to general anaesthetic. Encouraging comfort measures – whether a mirror, blanket, or support person – helps patients feel seen, heard and safe, regardless of whether a scan is completed. When care is grounded in compassion and patient autonomy, departmental data show measurable improvements in satisfaction and an increased likelihood of returning for future imaging. By humanising the MRI process, radiographers not only enhance scan success but also foster psychological safety and resilience within their practice. Everyone deserves access to the imaging they need – and when we listen, adapt and lead with empathy, we create lasting positive experiences in even the most intimidating environments. SPARK: Paediatric audiovisual distraction device implementation sparked adaptation for further inclusive radiotherapy treatment Aimee Welch 1 , Lucy Sim 1 , Narelle Wallace 1 , Jodi Mitchell 1 1 Princess Alexandra Hospital, Brisbane, Australia Audiovisual distraction has been demonstrated to be highly effective at reducing anxiety and use of daily general anaesthetic for paediatric patients during radiation therapy treatment. 1‐3 Limited commercial devices exist that enable visual distraction for patients receiving cranial or craniospinal radiotherapy without causing significant beam attenuation and impacting dosimetry. Therefore, SPARK: Screen Platform Assistant for Radiation oncology Kids, was developed for our department. TV shows, movies and other visual distractions are projected from a 3D printed articulating arm onto a radiotranslucent screen with sound transmitted from in‐build projector speakers (Fig. 1). Transmission and attenuation testing resulted in <0.1% attenuation to the screen alone and <1.5% when combined with other treatment compatible components. This device has enabled treatment to be successfully completed for paediatric patients who would otherwise have required general anaesthetic for all radiotherapy sessions. The clinical application of SPARK has since been expanded outside its initial scope, to ensure equitable care to other patient cohorts. Several radiotherapy techniques, including those involving inspiration or expiration breath hold, rely on verbal instructions during treatment. This is challenging for hard of hearing or culturally and linguistically diverse patients. In both cases, instructions, including those in multiple languages, can be projected onto the screen for patients to follow. Future work involves adapting SPARK for paediatric patients requiring cranial treatment with non‐coplanar arcs. The main challenge being navigated is developing a system that ensures non‐treatment compatible components are avoided for all beam arrangements. References 1. Willis D, Barry P. Audiovisual interventions to reduce the use of general anaesthesia with paediatric patients during radiation therapy J Med Imaging Radiat Oncol 2010;54(3):249–55. https://doi.org/10.1111/j.1754‐9485.2010.02165.x 2. Schulz JB, Zalavari L, Gutkin P, et al. AVATAR 2.0: next level communication systems for radiotherapy through face‐to‐face video, biofeedback, translation, and audiovisual immersion. Front Oncol 2024;14. https://doi.org/10.3389/fonc.2024.1405433 3. Gutkin PM, Skinner L, Jiang J, et al. Feasibility of the Audio‐Visual Assisted Therapeutic Ambience in Radiotherapy (AVATAR) system for anesthesia avoidance in pediatric patients: a multicenter trial. Int J Radiat Oncol Biol Phys 2023;117(1):96–104. https://doi.org/10.1016/j.ijrobp.2023.03.063 Sunday 29 March, 11:30 AM – 1:00 PM MRI in Focus (MI) Barriers to adhering to standard and transmission‐based infection control precautions in medical imaging Yobelli Jimenez 1 , Dania Abu Awwad 1 , Suzanne Hill 1 , Sarah Lewis 2 , Peter Kench 1 1 The University of Sydney, Sydney, Australia, 2 Western Sydney University, Penrith, Australia Introduction: Infection prevention and control (IPC) guidelines and training are essential for ensuring the safety of both patients and staff in healthcare settings. Inherent differences exist among various medical imaging professions, but adherence to correct IPC practices is essential. This study aimed to explore the scenarios and barriers to proper adherence to standard precautions (SP) and transmission‐based precautions (TBP). Methods: An online survey was shared across Australia among sonographers, radiation therapists, nuclear medicine technologists, and radiographers in X‐ray, CT and MRI modalities. Participants were asked open‐ended questions about adherence to SP and TBP. Results: A total of 409 participants completed the survey across the six professions. While 91 participants claimed to always adhere to IPC precautions, 330 and 305 issues were mentioned for SP and TBP, respectively. Time pressure was the most common factor negatively impacting adherence to SP, whereas communication was a more critical factor for TBP. CT radiographers reported the highest proportion of time pressures and communication challenges, followed by X‐ray radiographers and sonographers. Emergency factors were highest among MRI and nuclear medicine technologists, which included time‐critical scenarios, such as a patient having a panic attack or requiring transfer to a resuscitation bay. Conclusion: Common IPC practice challenges exist across the medical imaging professions, with time pressures being the main factor. Insufficient communication, handover and patient notes negatively impacted participants' ability to adhere to TBP. Efforts should be made to enhance communication practices between wards and medical imaging or radiation therapy departments. Bearing witness: Strategies for navigating non‐disclosure and emotional labour in medical imaging practice Megan Brydon 1 , Miriam Norman 2 1 Department of Health and Wellness, Halifax, Canada, 2 Royal Hobart Hospital, Hobart, Australia Medical imaging and radiation therapy professionals (MIRTPs) frequently encounter emotionally complex situations where disclosure of diagnostic findings falls outside their role. Despite being the first to observe pathology – often while alone with patients – MIRTPs provide compassionate and professional care without revealing critical health information. This unique ‘witnessing’ aspect of MIRTPs’ care provision can lead to feelings of therapeutic dishonesty and emotional burden. The mental health impacts of this dynamic – including burnout, compassion fatigue and vicarious trauma – are well established. Emerging literature further highlights the moral complexity of patient care, including moral injury (witnessing troubling events), moral distress (being unable to act), and moral residue (lingering emotional impact). For MIRTPs, these experiences may be intensified by their diagnostic insight, often knowing findings before the patient and broader team. This presentation explores how communication boundaries, role expectations and workplace culture shape these experiences and asks: Are we sometimes more silent than we need to be? We share scope‐compliant strategies that support both patient and clinician wellbeing. Real‐world examples illustrate how simple actions – such as explaining scan purpose, writing down key terms, or helping patients prepare for their doctor's visit – can build trust, improve health literacy, promote inclusion, enhance equity and strengthen the therapeutic alliance without breaching protocol. Participants will receive adaptable scripts, expectation‐setting phrases and communication prompts. Ultimately, this work reframes non‐disclosure not as passive silence, but as an opportunity for connection – one that preserves integrity, reduces emotional burden, improves practice and enhances both patient care and professional wellbeing. Navigating the complex landscape of infection prevention and control in MRI: Radiographer experiences, knowledge, practices Frances Gray 1 , Dania Abu Awwad 1 , Yobelli Jimenez 1 , Suzanne Hill 1 , Sarah Lewis 2 , Peter Kench 1 1 The University of Sydney, Camperdown, Australia, 2 Western Sydney University, Campbelltown, Australia Introduction: MRI represents a dynamic and often unpredictable landscape for infection prevention and control (IPC). MRI's unique environment, complex workflows and reliance on MRI‐compatible equipment create challenges for radiographers striving to maintain both standard and transmission‐based precautions. This study explores radiographers’ IPC experiences, knowledge, attitudes and practices to understand how radiographers navigate IPC challenges in MRI settings. Methods: A cross‐sectional survey was distributed to MRI radiographers across Australia. The survey investigated barriers to IPC adherence using open‐ended responses. Likert scale questions evaluated knowledge, attitudes and practices specific to IPC during intravenous contrast administration, with additional questions on training, policies and perceptions of infection risks. Data were analysed descriptively and thematically. Results: 52 radiographers provided 108 comments about IPC adherence. The most common challenges were workload pressures (33%), medical emergencies (25%), and poor communication (21%). Radiographers often remained unaware of patients’ infectious status until they arrived for scanning, thereby increasing the risk of infection during urgent or complex cases. Participant responses showed strong knowledge (93%) and positive attitudes (87%) towards IPC; however, practice was inconsistent. Only 66% of respondents always used standard precautions with patients, and adherence decreased (52%) when interacting with MRI equipment. Cleaning of high‐risk items such as contrast injectors and tubing was infrequent, with 25% of intravenous contrast equipment being cleaned more than once per day. Conclusion: Findings from this study expose the tension between knowledge and practice in MRI IPC. Despite radiographers’ commitment to safe care, systemic pressures, communication issues and limited MRI‐specific frameworks hinder adherence. Discovering patterns in imaging recalls: A baseline audit to inform quality improvement Alice Pattemore 1,2 1 Royal Brisbane and Women's Hospital, Brisbane, Australia, 2 Surgical, Treatment and Rehabilitation Service, Brisbane, Australia Introduction: In diagnostic imaging, patient recalls for additional imaging are sometimes necessary due to operator error or incidental findings not initially identified by the radiographer. While clinically justified in many cases, recalls can increase healthcare costs, cause patient inconvenience and anxiety, and delay diagnosis. Some recalls may be preventable, and minimising these is essential to improving patient care and departmental efficiency. As no prior audit had been conducted in our department, this project aimed to capture baseline data on imaging recalls to inform future quality improvement initiatives. Method: A 3‐year retrospective audit was conducted across all imaging modalities at a tertiary hospital. Examination type, reason for recall, delay to final report and patient impact were recorded. Recalls were classified as non‐preventable, operator error, or patient circumstance. Data analysis was limited to descriptive statistics. Results: A total of 195 imaging recalls were recorded, representing 0.03% of all examinations performed during the audit period. Recall rates by modality were: MRI 0.29%, CT 0.02%, ultrasound 0.01%, and X‐ray 0.01%. The most common reasons for patient recall are provided in Table 1. In approximately one out of 10 cases, documentation indicated that the recall caused patient anxiety. Main causes for delays in completing a recall examination were patient unavailability, transport limitations and difficult cannulation. Outpatients travelled a mean round‐trip distance of 79.28 km to attend recall appointments. Conclusion: These findings offer a benchmark for quality assurance and highlight opportunities to reduce patient burden through flexible scheduling and expedited reporting. MRI surveillance of intraductal papillary mucinous neoplasm: Discovering guideline adherence at a tertiary centre Neve Stewart 1,2 1 Royal Brisbane and Women's Hospital, Brisbane, Australia, 2 Surgical, Treatment and Rehabilitation Service, Brisbane, Australia Introduction: This study aimed to evaluate adherence to the Fukuoka 1 and the Kyoto 2 guidelines for MRI surveillance of low risk intraductal papillary mucinous neoplasms. It also sought to assess the impact of evolving guideline recommendations on clinical practice, particularly regarding imaging frequency and lesion progression. Methods: A retrospective audit was conducted on 124 patients undergoing MRI pancreas surveillance at an Australian tertiary hospital between April 2018 and April 2025. Lesion size, imaging intervals and radiology reporting were reviewed across 261 encounters. Surveillance accuracy was compared against the 2017 Fukuoka and 2024 Kyoto guideline recommendations, and lesion growth was analysed in relation to follow‐up timing. Results: Lesions ≤20 mm were the most common (73.45%), followed by 20–30 mm (16.90%) and ≥30 mm (9.66%) categories. Correct follow‐up rates varied: 43.75% for ≤20 mm, 60% for 20–30 mm, and 25% for ≥30 mm lesions. Mean lesion growth across groups remained low (2.04 mm, 4 mm and 3 mm, respectively). Larger lesions were not consistently followed up as frequently as recommended, and smaller lesions were often scanned more frequently than necessary (Table 1). Discussion/Conclusion: The audit revealed frequent deviations from recommended surveillance intervals, particularly for small lesions. Despite guideline updates in 2024, adherence remained inconsistent. Recommendations include extending surveillance intervals for stable ≤20 mm lesions to reduce departmental workload, improving education for referrers and implementing system‐level checks led by radiographers to support consistent practice. References 1. Tanaka M, Fernández‐Del Castillo C, Kamisawa T, et al. Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology 2017;17(5):738–53. https://doi.org/10.1016/j.pan.2017.07.007 2. Ohtsuka T, Fernandez‐Del Castillo C, Furukawa T, et al. International evidence‐based Kyoto guidelines for the management of intraductal papillary mucinous neoplasm of the pancreas. Pancreatology 2024;24(2):255–70. https://doi.org/10.1016/j.pan.2023.12.009 Validation of deep learning‐based super resolution for 4D flow MRI haemodynamic quantification Yicheng Wang 1 , Julio Sotelo 1,2 , Sergio Uribe 1 , Hernán Mella 3 1 Monash University, Melbourne, Australia, 2 Universidad Técnica Federico Santa María, Santiago, Chile, 3 Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile Introduction: Velocity‐derived haemodynamic parameters (HP) from 4D flow MRI are promising imaging biomarkers to stratify patients and guide treatments. 1 Their accuracy is compromised by the insufficient spatial resolution of 4D flow MRI. 2 Deep learning‐based super resolution (SR) techniques were developed to increase resolution, but their efficacy has not been widely tested in‐silico, in vitro or in vivo. 3 Our aim is to assess the SR impact on HP quantification for different aortic geometries, flow conditions and scanners to facilitate clinical translation. Methods: 4D flow data were obtained from: 1) normal and aortic coarctation simulations; 2) an aortic phantom under two haemodynamic conditions; and 3) 20 healthy volunteers. 4DFlowNet was applied to low‐resolution images for conversion into twice upsampled SR images. 3 The mean velocity, wall shear stress and energy loss were estimated for four aortic sections and compared during peak systole before and after SR. In phantom and simulations, high‐resolution ground truth was available for SR benchmarking. Results: SR recovered underestimated low‐resolution parameters to high‐resolution levels. A similar trend was observed in volunteers where SR measurements were significantly higher than low‐resolution measurements for all HP and sections (p ≤ 0.0002) (Fig. 1). The SR low‐resolution differences increased from the ascending aorta to the distal descending aorta. HP ranked by their sensitivity to SR from most to least were energy loss (251%–1133%), wall shear stress (37%–83%) and velocity (7.5%–18%). Conclusion: SR can improve HP accuracy by resolving fine‐scale flow features, with robustness against geometry and flow variations. References 1. Sotelo J, Franco P, Guala A, et al. Fully three‐dimensional hemodynamic characterization of altered blood flow in bicuspid aortic valve patients with respect to aortic dilatation: a finite element approach. Front Cardiovasc Med 2022;9:885338. https://doi.org/10.3389/fcvm.2022.885338 2. Montalba C, Urbina J, Sotelo J, et al. Variability of 4D flow parameters when subjected to changes in MRI acquisition parameters using a realistic thoracic aortic phantom. Magn Reson Med 2018;79(4):1882–92. https://doi.org/10.1002/mrm.26834 3. Ferdian E, Suinesiaputra A, Dubowitz DJ, et al. 4DFlowNet: super‐resolution 4D flow MRI using deep learning and computational fluid dynamics. Front Phys 2020;8:138. https://doi.org/10.3389/fphy.2020.00138 Articles from Journal of Medical Radiation Sciences are provided here courtesy of Wiley ACTIONS View on publisher site PDF (3.3 MB) Cite Collections Permalink PERMALINK Copy RESOURCES Similar articles Cited by other articles Links to NCBI Databases Cite Copy Download .nbib .nbib Format: AMA APA MLA NLM Add to Collections Create a new collection Add to an existing collection Name your collection * Choose a collection Unable to load your collection due to an error Please try again Add Cancel Follow NCBI NCBI on X (formerly known as Twitter) NCBI on Facebook NCBI on LinkedIn NCBI on GitHub NCBI RSS feed Connect with NLM NLM on X (formerly known as Twitter) NLM on Facebook NLM on YouTube National Library of Medicine 8600 Rockville Pike Bethesda, MD 20894 Web Policies FOIA HHS Vulnerability Disclosure Help Accessibility Careers NLM NIH HHS USA.gov Back to Top