Bridging Theory and Practice in Radiology Education with Christopher Clarke

Episode Overview

Episode Topic: In this episode of Skeleton Crew – The Rad Tech Show, we delve into the crucial roles of Communication and Technology in Radiology, providing a comprehensive understanding of how these elements are pivotal in the current landscape of healthcare. Christopher Clarke, a seasoned consultant radiologist at Nottingham University Hospitals NHS Trust, unveils the intricate ways in which modern technology and effective communication methodologies are transforming radiology departments across the globe. This discussion is not only a reflection on the current state but also looks at the future of radiology as influenced by continuous technological advancements and enhanced communication strategies.

Lessons You’ll Learn: Listeners will gain valuable insights into the practical applications of Communication and Technology in Radiology through this enlightening episode. Christopher Clarke shares his firsthand experiences and lessons learned from incorporating cutting-edge technologies and robust communication protocols in his daily practice. The episode covers the impacts of these advancements on diagnosis accuracy, patient safety, and overall healthcare delivery. Clarke’s experiences offer listeners a unique look at the challenges and solutions found in the dynamic field of radiology, emphasizing the importance of staying updated with technological trends and communication skills.

About Our Guests: Christopher Clarke is a respected consultant radiologist specializing in gastrointestinal imaging at Nottingham University Hospital, with a keen focus on enhancing Communication and Technology in Radiology. With over a decade of experience in the field, Clarke has contributed significantly to both the clinical and educational aspects of radiology. His work on RadiologyCafe.com, an educational resource for radiology students and professionals, underscores his commitment to improving the radiology field through shared knowledge and communication. Clarke’s expertise is not just limited to clinical practice but extends into his active involvement in developing new protocols and teaching methods that incorporate advanced technologies and communication strategies.

Topics Covered: Throughout the episode, we cover a wide array of topics related to Communication and Technology in Radiology. Starting with an overview of how communication plays a crucial role in diagnostic processes, Christopher Clarke discusses the integration of new technologies such as AI and advanced imaging techniques in clinical settings. The discussion also touches upon the educational aspects of radiology, where technology and communication are leveraged to enhance learning and professional development. Additional topics include the impact of these advancements on patient management and the future directions of radiology practices, especially in the context of improving diagnostic outcomes and patient-centered care.

Our Guest: Dr. Christopher Clarke- Leading the Way with the Approach to Communication and Technology in Radiology

Episode Transcript

Christopher Clarke: We’re quite firm with those clinicians. If we get a request that’s not great, we’ll just say no and throw it back to them and say, what do you want here or email them or just say, “Look, I don’t know what you’re asking for here. Can you tell us and explain?” We don’t accept sort of, they’ve got some pain here. Do a scan. So we wouldn’t do that because it’s not very helpful. But the better the communication with us, the better we’ll communicate with them and give them the answer that they want, rather than sort of a vague descriptive report. We can go straight for what they want to look for, which is nice.

Jennifer Callahan: Welcome to the Skeleton Crew. I’m your host, Jen Callahan, a technologist with ten-plus years of experience. In each episode, we will explore the fast-paced, ever-changing suburbs, and the completely crazy field of radiology. We will speak to technologists from all different modalities about their careers and education, the educators and leaders who are shaping the field today, and the business executives whose innovations are paving the future of radiology. This episode is brought to you by xraytechnicianschools.com. If you’re considering a career in X-ray, visit xraytechnicianschools.com to explore schools and to get honest information on career paths, salaries, and degree options. Hey, everybody, welcome back to another episode of the Skeleton-Crew. I’m your host, Jen Callahan, and today I have a great guest with me. His name is Chris Clark. He is a consultant radiologist at Nottingham University Hospital, which is located in England. So he’s joining me from across the pond. He’s got a wealth of knowledge in GI imaging, hepatobiliary, and emergency. He’s got his hand in a bunch of extracurriculars that I’m interested to talk to him about. So Chris, thanks for being with me today.

Christopher Clarke: Thank you. It’s wonderful to be here.

Jennifer Callahan: I first want to ask, a consultant radiologist, is that a term that’s used in Britain or England or what exactly does that mean?

Christopher Clarke: I guess you call it is call it of attending. I guess you head the team up basically. So We all call consultants in England Then in the community general practitioners Then our trainees are called registrars. The terminology is slightly different. I’ve been exalted for five years.

Jennifer Callahan: All right. That makes sense now. Thank you. So while we’re talking about since you are attending and you have the registrars underneath of you, the trainees, I kind of want to jump off with this website that you put together called radiologycafe.com and it’s for students who are out there. Is it for the students who are looking to get into radiology, or is it for students who are currently in radiology Then for them for when they’re leaving?

Christopher Clarke: It’s a bit of both. So initially it was I started it in 2011 and back then there was nothing really for people applying to radiology to know what the process was or how to get in. I went through the process and the interviews, and I put all the information about how the UK system works to help people, and that was useful. Then as I went through my training, I added more and more learning resources. So now it’s got sort of mock exams for our radiology exams in the UK, we have a Royal College called the Royal College of Radiologists, That’s who we all kind of register under. All the trainees have to pass the Royal College of Radiologists exams. So there’s anatomy and mock questions and some physics stuff online as well, which I’ve added to the website.

Jennifer Callahan: That’s definitely like super helpful. I remember doing mock exams for myself, becoming like a rad tech, so I can only imagine how much more in-depth, obviously the boards that radiologists are taking and how I’m sure useful something like that is for students. They’re so nervous, taking these tests that you can prepare yourself is really what you need to do.

Christopher Clarke: We have two exams at the beginning of trading anatomy in physics. That’s what my website concentrates on. The anatomy is fun and easy. I’ve got lots of mock questions, but the physics is hard and I’m sure you guys have to do physics as well. It’s a lot of facts and numbers and things. So I did the anatomy. But I worked with a colleague, Sarah Abdullah, who wrote some really good physics notes, and I kind of reached out to her. Then we kind of linked up and put her notes on the website as well. It’s nice to share them with people.

Jennifer Callahan: When you talk about physics, are you talking in terms of the patient or do you mean with the radiology equipment?

Christopher Clarke: Ours is mainly radiology equipment. It’s the physics of X-rays, CTs, and MRI. There’s nothing in our exams really about patient positioning and things. That’s much more sort of radiographer. So we don’t learn that in great detail.

Jennifer Callahan: I remember the physics. Did you have to learn about generators and the currents and things that you’re talking about? I remember it, I remember learning it. I could not repeat it back to you right now because I feel like once I took my exam, it sadly went out of my head.

Christopher Clarke: There’s knowledge and there’s like working knowledge, isn’t there?

Jennifer Callahan: Radiology Cafe, obviously, you said is helping to prepare students. Do you also help them in other senses maybe like helping them find a job or do you have other colleagues that help post on the cafe site about institutes that are looking for new doctors?

Christopher Clarke: It doesn’t do that. I did think about it, but there are better websites out there that do that. So I’m not trying to rewrite, fantastic websites already doing that out there and try and do it again. But it does have advice on when you’re applying to consultant jobs, like mock interview questions that might be asked, where to apply, and some advice on setting up your job, kind of more general advice, but it doesn’t have specific job adverts. I did put some stuff for medical students on there as well, which I think certainly we get people from all over the world looking at that, including America. It’s called Radiology Basics, and it’s a really basic overview of CT and X-rays for medical students. Pulmonary embolus, this is a diverticulitis. These are a few basic pathologies with some explanations. It’s quite simple but it’s quite a nice little overview. So I put that on there cause that’s quite helpful.

Jennifer Callahan: Especially, you said like mock interview questions and things like that, so sitting for an exam your heart’s pounding, you wouldn’t try to be as prepared as possible but going out for your real first interview for your new profession probably has your heart racing and stuff and so many different places conduct their interviews differently. Some people are very scripted and have questions that ask you, and they’re going down and they’re checking off the questions that they have to ask. Then other places just want to get to know you as a person and then might be talking about the career and the position itself, intermittently through. It’s kind of more conversational-based. Either way, again, being prepared is the name of the game for newbies, I feel like.

Christopher Clarke: Actually, it’s interesting. In the UK, it used to be when I did it, you had interviews with each sort of area and now it’s all nationalized. So actually the UK the last few years it’s all been centrally coordinated and interviews, I think since Covid moved on to teams as well. So it’s all online and it’s fairly scripted now, so everyone gets the same experience. To get into radiology, you have to do an exam. Then you prioritize based on the exam and then you have the interview. So it’s quite a big process. I’ve tried to keep the website up to date with all the changes because it’s changed a lot since I applied.

Jennifer Callahan: How long have you been practicing?

Christopher Clarke: I’ve been a consultant for five years. I did my training, I finished med school in 2009, Then I did a few years of junior doctoring and then, radiology training from 2011 to 2016, then did a fellowship at one of the other hospitals in the UK Leeds, a very good center for GI. So I did a year there and then went back to Nottingham, to Nottingham for the last five, six years.

Jennifer Callahan: All right. So let’s talk about Nottingham then. Is it a fairly large hospital?

Christopher Clarke: It’s big, I think so. There are two hospitals in Nottingham. One is called the Queen’s Medical Centre and it’s a huge building. I think at one point it was one of the largest in Europe. It’s a huge complex. It’s like five squares from above. It’s like five squares, all interlinked. But it’s a bit of a maze. I get lost in it, colleagues get lost in it. They’ve worked in it for ages. It’s just massive. We’re a major trauma center for the region, so we see a lot of trauma, a lot of we’ve got our main motorway for the UK running close by. I think a lot of car accidents and hurts. So a lot of emergency imaging. We’re a tertiary referral center for a lot of cancers, and we’re a neuroradiology kind of specialist sort of quaternary center, which is national meets on the neuro side. So it’s very specialist there. That’s not me though. I’m GI, so I’ll let my colleagues sort that out.

Jennifer Callahan: What drew you to GI that you wanted to specialize in that?

Christopher Clarke: It’s the clinicians, I think. So it’s interesting, you go through training and some specialties. You don’t have as much interaction with the clinicians. You kind of report scans or doing things, but they’re doing their own thing. Whereas, in GI, every day they’re coming and chatting to us ask, “Can you show us this scan? Can we look through this or can you come to the theatre? Help us with an ultrasound of a patient that’s on the table and look for a lesion.” It’s just really nice working with them, especially the gastroenterologists doing a lot of Crohn’s. We do a lot of Crohn’s imaging in our center, so it’s quite nice working with them. They do a lot of research and they’re a nice team. That’s the reason, it’s a friendly sort of team to work with.

Jennifer Callahan: You’re doing GI and then Hepatobiliary and you were saying how you go in and you do like ultrasounds and stuff. Are you hands-on in other areas do you go and say like the x-ray department and do fluoroscopy for like upper GI which I feel like in America is not completely obsolete?

Christopher Clarke: When I started trading I did two or three animals a week and now it’s completely gone. It’s all CT colon now, so no, but I do go in a lot. I tend to go in probably more than my colleagues because we all have home computers, so we can all work from home and do it all remotely as well as go in. But within our team, we have a team of about ten people in GI, HPB and we all go in. We all do a bit of fluoroscopy, ultrasound intervention, we all do nonvascular intervention. So we put in gastrostomy feeding tubes, Ng tubes. We also help with the on-call with nephrostomy, ostomy exchanges, any drains, and biopsies. We do all of that. So we do that as well as do sort of the diagnostic side. It’s quite nice to get a nice mix quite well. Mdt so when you’re discussing the cancer patients at the meeting, rather than ask someone else, you can say, you can buy up to that, or you can drain that Then you can arrange it and then the next day do it. So you don’t have to refer to colleagues. You can just do everything within the team which is nice.

Jennifer Callahan: That you don’t have to wait for the interventional department to get back to you. You know, can they get this patient on?

Christopher Clarke: We don’t do, obviously, the vascular work. We have a separate vascular intervention team to do the EVAs and all that sort of stuff. So they refer to them for that. But most of the sort of body abdominal stuff we’ll do.

Jennifer Callahan: That’s nice though. You’re in control of your schedule and we can just do it tomorrow. So that’s great for patient care that you’re not waiting to “When can this be done and stuff?”

Christopher Clarke: We have a huge issue with the shortage of radiologists in the UK. We do have some backlogs for reporting, which is not great. But we do prioritize the inpatients and try and get done quickly. So the inpatients, the same day they come down, we get the draining, sorted it all out quickly.

Jennifer Callahan: With GI imaging, do you like are there any challenges that you feel like that you face with it? Maybe doctors don’t order them properly or proper studies are not ordered.

Christopher Clarke: Kind of. We’re quite firm with those clinicians. If we get a request that’s a bit that’s not great. We’ll just say no and throw it back to them and say what do you want here? Or email them or just say, “Look, I don’t know what you’re asking for here. Can you tell us and explain?” We don’t accept that. “They’ve got some pain here, do a scan.” So we wouldn’t do that because it’s not very helpful. But they’re generally very good. They know that the better the communication with us, the better we’ll communicate with them and give them the answer that they want, rather than sort of a vague descriptive report. We can go straight for what they want to look for which is nice.

Jennifer Callahan: Also too, like maybe from the equipment standpoint, do you find that maybe you’re looking for something specific and you find that you hit a challenge of what you’re exactly you’re looking for, or maybe the type of scan that you’re looking for?

Christopher Clarke: That happens sometimes. But we have access to MRI, CT, all the things that we need. So sometimes we’ll do a test and it’s not right. We’ll say you need to get an MRI and an MRI Then we’ll do an MRI or sometimes we just change it and just do it. It depends on the referral. We’re quite flexible. So some people might request an MRI when they need a CT. So we’ll just change it to a CT and say look we just change the CT. Our clinicians are very happy with us doing that, choosing the right test for whatever the question is. It works quite well, really getting any sort of conflict. There’s not like, oh, I want this test, why can’t you do it? Because we always see it. Now we explain why, “This is the better test, do this one and why.” Everyone understands it works. It works well.

Jennifer Callahan: Looking at a CAT scan versus MRI, is one better for certain diagnoses or diseases and others because of the cross-sectional anatomy? I mean, you have both, but the images are different?

Christopher Clarke: Definitely. There’s a cost difference. So if you’ve got an older patient and you get the same answer, go for CT. If you have someone’s younger, you want to avoid the radiation and you get the same answer. We go for MRI, but generally, they are different indications. Someone’s acutely unwell, they’re sick. They’ve got bowel obstruction, they’ve vomited. They always get a CT. We don’t want to put them in the scanner, the MRI lying down for a while. You know, if you’re looking for Crohn’s disease or you’re looking for fistulas or things like that, they’re much harder on CT. So we’ll do an MRI for them. It depends on what the indication is. Certainly, rectal cancer always gets an MRI much, much better than CT. But depending on CT, colons are fantastic for colon cancer. So we do quite a lot of CT colonography now we have a good endoscopy service. So do you know they do thousands of colons a year? But I think we do roughly 2000 CTCs a year. Some centers do a lot more and sometimes do less. But we’ve got a very good endoscopy service. So we don’t tend to do. Many of some of the centers. But we find that we’ve got a really good advanced practice radiography team doing our CT colonography. We’ve got a team of, I think, seven radiographers that are all trained up to do the examination, put the tube in and they do the provisional report as well. So they do an initial report of the colon and, and the findings. Then the consultant checks it and goes through it again. But training them up and doing that has been a fantastic improvement to the quality of scans and getting the service done, it’s made a big difference.

Jennifer Callahan: What is it between CT and MRI imaging that you had said MRI is better for rectal cancer, but CAT scan is better for colon cancer? What is it between the images that make one better than the other?

Christopher Clarke: That’s a good question. It’s just the resolution, isn’t it? So it depends on what the question is for rectal cancer. You want to know in detail how far the tumor is invading through the wall of the rectum. You can get that detail with an MRI. You do lots of sequences. With CT you just get a snapshot and it’s just gray and gray on the fat, and you can’t see the layers of the wall. On MRI, you can see the individual layers of the bowel wall. You can see the muscle muscular on the outside, the submucosa, and then the mucosa. You can see how far the tumor is going through. It’s much easier to see if the tumor is invading veins, which is important, or if it’s going to lymph nodes, and you can see if there are enlarged sort of abnormal nodes, the side of the scan. It’s a lot easier to do that with the MRI than the CT.

Jennifer Callahan: I didn’t realize that the image was that different in terms of that. It was more in-depth. That shows more information just in a different way. That Cat scan would just turn up looking grey. It’s interesting.

Christopher Clarke: CT’s better for loads of things. The resolution of CT tends to be pretty good, but the MRI of the rectum, it’s a really good resolution and you do lots of views as well. And you align the scan with the plane of the tumor. So you can see you get a nice cross-section which you can’t always get with the CT. So now it’s just different. We have a lot of protocol-driven stuff. So you know, for this, you have this, for this, you have this. So it’s very clear what scan we do for what indication usually.

Jennifer Callahan: Do you help write the protocols for the department?

Christopher Clarke: We do work with the radiographers to get the protocols. In fact, my colleague today this afternoon was doing a list of small bowel MRIs on the scanner to kind of get the fat saturation sorted out because it’s not very fat saturation on a small MRI is a bit needs a bit of improvement. So hopefully we’ve done that this afternoon. So that’s good.

Jennifer Callahan: Do you go back and review your protocols like maybe once a year to see if they need to be changed or if they can be improved?

Christopher Clarke: We probably should do that. We kind of review them as we go along. If we notice something we’ll then work on it and improve it. So we tend to come in bursts and then we leave it for a few years, usually, it’s when we get a new piece of kit. So certainly when we get a new scanner in like obviously everything’s different sequences. You have to kind of change everything. Or if you know, this new evidence comes out, there’s a new sequence and we’ll put that in. We do a lot of we do a lot of small bowel MRIs. I don’t think you have so much Crohn’s in America. I don’t know if that’s very common or not.

Jennifer Callahan: I think that it is. I’ve worked in a few different health systems, and there’s a fair share of patients that you would see come into the ER. Especially the first hospital I ever worked at was a smaller hospital, and you would have the same patients come in quite often who would come in for flares of Crohn’s. I feel like it was pretty common and then they would have to stay. Then they were constantly getting obstruction CT.

Christopher Clarke: That’s cool. That’s one of the things we’re doing is we’ve added some motility sequences on the MRI. So let’s do that for a few years where you’re looking at the movement of the bowel a bit like the cardiac sort of CT images. I think it’s over 20 seconds, you see a 22-second snapshot of all the bowel movement. It’s really good because the bowel tends to move when it’s normal. When you’ve got the Crohn’s, it just doesn’t move. It’s stark in the images. So we’ve been doing that That’s been quite helpful. So sequences, things like that that we add in and try and help us.

Jennifer Callahan: We’re going to transition real quick from you being an attending there at Nottingham, but also to you being in charge of something that you also to author many textbooks. You’re like a jack of all trades here.

Christopher Clarke: I did them a little while ago now. I’ve just got a four-month-old, so I don’t have any time to do anything like that.

Jennifer Callahan: Congratulations.

Christopher Clarke: Thank you.

Jennifer Callahan: What type of textbooks were you helping editing or writing, I guess?

Christopher Clarke: I did a book on chest X-rays. It’s called Chest X-rays for medical students, and I started that when I was at med school. We didn’t have a teaching resource. It was for the medical school. Then I took it to the school to print out and they said, oh, why don’t you try and get it published? So I did that and a few years later got it. It was great. Got a book, and I like working with Photoshop and doing things. So I took the images and colored them in and added everything. That was quite novel at the time. Again, now it’s all over the internet, everyone does this, but back then, back in 20, was it when that was 2009? It was quite novel and that did well. It was a sort of very basic of chest x-ray interpretation, with kind of all the different conditions and little mnemonic to go through. And I did the same for abdominal X-rays. And it’s funny because that came out in 2016 and it’s called abdominal x-rays for medical students. But nowadays we don’t do that many abdominal x-rays. So we did quite a lot back then. But now it’s CT. We replaced a lot of it with CT. I wrote the guidelines to change from CT, so kind of did the textbook Then shot myself in the foot. Maybe I’ll look at the chest x-ray book again, but I think things have changed since I did that because, um, nowadays there’s so much stuff online that you don’t need that many textbooks anymore. So back then it was you need the books. So I’m not sure if. Get a second edition of the chest x-ray book. But, um, I wonder if we need a third. To be honest, if they come to me, I’ll probably say, okay, we’ll work on it. But I’d be surprised.

Jennifer Callahan: Maybe they could publish it that’s available that you couldn’t get as an e-book kind of? You know what I mean.

Christopher Clarke: It’s available as an e-book so you can get it as an e-book. But as I said, there’s so much stuff online for free now that it has to be good. I think it is good. But there’s just so much stuff out there now, you’re spoilt for choice now with all the different resources and learning resources. I wonder if we did another one, whether it would be sort of a website version or something.

Jennifer Callahan: I have to say that I find at least when it comes to school and learning, there’s something very much like tangible about having a book in front of you, having a highlighter. That was the way that was good for me to learn. So, I mean, I love the internet, as you said, it’s a wealth of information, so much out there. But having a book in hand sometimes when you’re learning something new especially is very helpful.

Christopher Clarke: I agree with you. I’m just not sure that I represent the new guys coming through now because they’re so used to technology. They’re just different. Maybe they still go for a book, I don’t know. But we did. So it’s on Radiology Cafe. I have loads of physics notes for the whole curriculum for the physics, and we made them into a book. And you can get that as a book. People do buy that. I do think that there’s certainly something in it that you say, as you say, of having it in paper and highlighting it, it does make a difference. I find it much easier to learn that way.

Jennifer Callahan: Another thing one discussed is that you have your hand in Rogan Fest. So this is a conference that you helped start up or were you the initial person behind it?

Christopher Clarke: I wasn’t. This is one of my colleagues, Jackie Kennedy. It’s her brainchild. So it’s Rogan Fest. It’s named after William Rogan, who discovered X-rays. It’s a bit of a play on his name, and it’s a local sort of regional academic research meeting that we do in Nottingham, mainly for our trainees, so they can share all the audits and all the research they’ve done over the year and present them to others so we can all share and also just get out the hospital for a day and have an environment where the consultants and the registrars are the attendings and the what’s the word, the registrars in America, I forget attendings and residents. Residents, that’s the one. So don’t use that at all. In the UK, uh, where they kind of mix the chat and just informally and we invite all the hospitals in the region. So it’s quite nice to see colleagues that you don’t see very often. Cheika started about 10, 15, ten years ago. They stepped away about seven years ago. Then I took over sort of chairing it. We go to sponsors to get the money to pay for the event.

Christopher Clarke: We’ve managed to do it for free for the last few years with everyone for lunch and food and things paid for by the sponsors who kindly come and we get 5 or 6 to kind of sponsor the event. It’s really good fun. I did it for the last time last year. I did it for 4 or 5 years, and I had to step away because I’m too busy with other stuff now, so I’ve handed it over but worth doing. I think sometimes our trainees don’t get exposed to research enough, so it’s really good to get them to see examples of really good practice so they can share, you know, okay, this is what I did. And sometimes all the pathways are very different for different consultants. And you see like okay, I didn’t do a PhD, I didn’t do this. But this is how I got into research. I did this project, this project, and we kind of got them as role models to present to the trainees, to show them this is what you can do, That’s quite good.

Jennifer Callahan: I was looking on the website and I found it interesting that I guess you guys try to keep it light a little bit, where you do different awards for people that are there for research. I saw the different names. I feel like some of the names were kind of playful for the awards. You do awards in general though, which is nice.

Christopher Clarke: We do awards. I don’t think we are playful. I think they’re boring names. We had a poster award and a research award for best Audit and Quality improvement. But no, again the sponsorship pays for that. So it’s a couple of hundred pounds. Then I think it’s £400 for the research award. Actually, that research award is not paid for by the sponsors. That’s a grant that we were given by the family of one of our registrars who sadly died a few years ago, and they left us quite a lot of money in a charity to support research. So every year we use a bit of that to pay for the research price. It was quite nice.

Jennifer Callahan: Nice. That’s great. Do you know what the best Research award was for this past year?

Christopher Clarke: Now you’re asking me, I can’t remember, they’re all very good. The answer is they were all very good. Okay, we choose the best. The abstracts are submitted. We choose the best for to do an oral presentation using sort of 3 or 4 judges on the day. We just pick 5 or 6, 3 or 4 consultants to judge, Then they will just pick a winner on the day. So it is based on just who does the best on the day. It’s quite good it’s even playing field.

Jennifer Callahan: Have you ever been a part of the Rogan Fest?

Christopher Clarke: Actually, yes. I think I got one of the prizes for one of the audits when I was a trainee back in the day, but no, it’s just a nice way of recognizing the achievements that the registrars do. They don’t often get that they’re so busy working and doing things, it’s quite hard to. So it’s nice to have a day where they can just celebrate them and we mix it with education. So it’s not just all audit research. It’s kind of over 50-audit research. The 50 people coming in and giving educational talks and their teaching. So it’s the consultants also get something out of it, as well as seeing all the research that’s going on in the region.

Jennifer Callahan: Kind of switching from research which finding out all new types of information from the registrars Then at the rank and fest, looking into the future in terms of imaging and equipment for the world of radiology, is there anything that you had your ear down to the ground that you’ve possibly heard about or maybe something that you’re thinking in your mind that would help aid in your in like GI and Hepatobiliary imaging?

Christopher Clarke: I think apart from obviously the AI, we’ll see how that goes. We’re doing a few projects on that. But I think that’ll take a little while to get in. The photon counting stuff that Siemens is doing with CT scanners is good. I’m sure the other companies are all working on stuff at the moment that’s similar, and I’m quite keen to see where that goes with the fluoroscopy with intervention because I think as soon as we get that technology in the detectors, which hopefully won’t be too far off, that will be a step change and hopefully I’m hoping that will lower the doses. I mean, we could do a lot more things, give us a much better image quality and help, particularly some of the vascular stuff, I suspect.

Jennifer Callahan: What exactly would the photon counting do? Explain that to me, because I mean, I know I know what photons are. I’m sorry to get technical, but I’m interested. You said it’s going to be a really good development. I know personally what photons are. But when you say photon counting, I don’t know.

Christopher Clarke: There are new CT scanners now. They look at the energy of each sort of photon. This is my understanding. I think if a physicist is listening, they’re probably going to be screaming at me in the camera. But with my radiology head-on, I’m not a physicist, but my understanding is that the detectors are much more sensitive. They can detect not just the individual energy of each photon, which means you get a lot more information. You get a lot more signal, which means you can lower the dose or get a lot better resolution. And either one of them is great. And I know that they’ve got this technology in CT. I don’t fully understand it and maybe it won’t work in other modalities, but I can’t see why someone clever can’t put it in an x-ray detector, and that will make a big difference. I think hopefully, particularly from the high dose fluoro stuff we do, I’m keen to see which companies come out with that and what they do with that because I think that would be really great.

Jennifer Callahan: Basically, they’ll be producing a great image, but lowering the patients and then lowering the dose for the doctor and the technologists that are within the room.

Christopher Clarke: Lowering the dose or you have the same dose but a much better resolution. Either one has sort of benefits depending on.

Jennifer Callahan: You heard that Siemens is developing something like this.

Christopher Clarke: They’ve got the photon counting CT scanner. I don’t know if other CT scanners do it, but I’m sure the other companies are working on it. It’s like if everything in radiology, one company does it a few years later, everyone else follows suit. So I’m sure.

Jennifer Callahan: They just want to do it just a tad better if they can. But everyone jumps on the bandwagon.

Christopher Clarke: I’m sure there’s stuff that’s worked on at the moment, but I’ve only heard of it in CT. But I’d be amazed if there’s no playing film and lurid stuff coming out in the very near coming months, or probably unveiled at RSNA come December.

Jennifer Callahan: Always new great developments coming out from different conferences like that. All right everybody, well, this is Chris Clark with me discussing the realm that he’s in GI Hepatobiliary, you know, being in attending or consultant, as I learned today, and all the different things that he has going on while he has a baby as well. So, Chris, thank you for taking time out of your busy schedule to be with me. I appreciate it.

Christopher Clarke: Thank you. It’s wonderful to be here.

Jennifer Callahan: Everybody, we’ll see you next week. Make sure you check out other episodes and future episodes. Leave us some reviews so we know what you think. We are on Apple Podcasts, Spotify, and then also YouTube. You can find us. All right, this is Jen and Chris and we’re out of here for the day. You’ve been listening to the Skeleton-Crew, brought to you by xrayTech.org, the Rad Tech Career Resource. Join us on the next episode to explore the present and the future of the Rad Tech career and the field of radiology.