Rediscovering radiology: New technologies and remedial action at the worksite

Abstract

This study contributes to social studies of imaging and visualization practices within scientific and medical settings. The focus is on practices in radiology, which are bound up with visual records known as radiographs. The study addresses work following the introduction of a new imaging technology, tomosynthesis. Since it was a novel technology, there was limited knowledge of how to correctly analyse tomosynthesis images. To address this problem, a collective review session was arranged. The purpose of the present study was to uncover the practical work that took place during that session and to show how, and on what basis, new methods, interpretations and understandings were being generated. The analysis displays how the diagnostic work on patients' bodies was grounded in two sets of technologically produced renderings. This shows how expertise is not simply a matter of providing correct explanations, but also involves discovery work in which visual renderings are made transparent. Furthermore, the results point to how the disciplinary knowledge is intertwined with timely actions, which in turn, partly rely on established practices of manipulating and comparing images. The embodied and situated reasoning that enabled radiologists to discern objects in the images thus display expertise as inherently practical and domain-specific.

Chest Tomosynthesis: Technical and Clinical Perspectives

“…A recent report from the Dutch-Belgian Randomized Lung Cancer Multi-Slice Screening Trial 56 pointed out that no perifissural nodules turned out to be malignant after 5.5 years of follow-up and recognition of these nodules can reduce the number of follow-up examinations. Perifissural nodules was also the example of a false positive nodule elaborated in the study on chest tomosynthesis by Rystedt et al 57 However, according to our experience it is possible to identify morphological properties of a perifissural nodule on chest tomosynthesis, when the nodule and fissure is depicted in the same image.…”

“…The follow-up study performed after an additional year of clinical use showed no additional increase in detectability, indicating that experienced thoracic radiologists are able to exploit the benefits of chest tomosynthesis for nodule detection already after a few months of clinical experience with the technique. 73 In the study by Asplund et al 38 it was also found, regarding the task of nodule detection, that inexperienced readers could reach a performance at the level of an experienced thoracic radiologist after participating in a dedicated learning session, described in detail in Rystedt et al 57…”

“…Several studies have focused on the learning aspects associated with chest tomosynthesis, mainly regarding the use of the technique for detecting pulmonary nodules. 38,57,73 The study by Zachrisson et al 73 is a follow-up study to a previous study by Vikgren et al, 6 in which the performance of chest tomosynthesis was evaluated by comparing the detectability of parenchymal nodules with this method and conventional chest radiography. In a patient material containing a total of 131 nodules identified in 87 patients using CT, experienced chest radiologists managed to detect on average only 16% of the nodules using chest radiography, while the corresponding percentage using chest tomosynthesis was 56%.…”

Dismembering organisation: The coordination of algorithmic work in healthcare

“…However, unlike these studies, our attention is not fixed on opening the algorithmic 'black box' (e.g. Johnson, 2007;Rystedt et al, 2011). Rather, we attend to the manner in which the algorithm and its output become embedded in, and are ultimately disruptive for, field level dynamics (c.f.…”

The body in medical work and medical training: An introduction

“…In order to discern the relevant features of a clinical object, there is a need for anatomical visibility. Several of the studies demonstrate the important role of imaging technologies, such as microscopes, endoscopic cameras and ultrasound scanners, in the achievement of this (see also Lindwall et al, 2014, forthcoming;Mondada, 2003;Nishizaka, 2011;Rystedt et al, 2011;Slack et al, 2007).…”