Keywords magnetic resonance imaging - remote scanning - radiographers
Introduction
The digital transformation in health care can change how patient care and services
are delivered.[1 ] Incorporating advanced digital technologies into medical imaging services has already
enabled telediagnosis and the operation of sophisticated imaging systems, such as
magnetic resonance imaging (MRI) scanners, enabling health care professionals to perform
imaging procedures remotely.[2 ]
[3 ] Remote MR scanning has emerged as a potential solution for supporting radiographers
and technologists from a distance during complex MRI procedures.[4 ] Remote MR scanning refers to the ability to operate and monitor MRI procedures from
a location that is physically separate from the MRI scanner site. The key components
of remote MR scanning are: (1) the physical location where the MRI scanner and its
workstation are installed, (2) the remote workstation, which is a secure computer
system or interface used by the remote radiographer to control scanning parameters
and monitor the procedure in real time, (3) a high-speed, secure internet connection
enabling real-time communication between the MRI scanner and the remote workstation,
(4) audio and video systems, allowing real-time interaction between the remote and
on-site radiographers.[5 ] An oral presentation on remote MRI scanning technology and a demonstration of commercially
available software were delivered at the First Greek Radiological Technologists Conference
held in November 2024 in Athens, Greece, followed by an electronic survey among attending
radiographers. The objective was to explore radiographers' acceptance of remote MR
scanning technology in Greece rather than the software itself used.
Materials and Methods
Anonymous responses were collected during the conference, using an electronic questionnaire
in Google Forms.[6 ] Each radiographer who attended the oral presentation and the remote MR scanning
technology demonstration was eligible for the survey. A social media campaign followed,
inviting radiographers with prior experience through the use, demonstration, or training
of this technology to participate in the electronic survey voluntarily and anonymously.
The Greek-translated version of the Technology Assessment Model (TAM) was used for
our survey, which comprises four distinct sections with 19 statements that explore
the p erceived e ase o f u se (PEoU), p erceived u sefulness (PU), a ttitudes t oward t echnology (ATT), and b ehavioral i ntention to use the technology (BI) on a five-point agreement Likert scale.[7 ] An open-ended question was included to gather respondents' opinions regarding the
adoption of this technology, workflow management, human resource issues, and professional
matters.
Our survey was conducted as independent research. Approval from an Institutional Review
Board was not obtained. However, permission from the organizing and scientific committees
of the conference to conduct this survey was obtained. All participants were electronically
informed prior to completing the questionnaire that their responses would remain anonymous
and confidential, and provided an electronic consent.
Results
[Fig. 1 ] shows the demographic characteristics of the 35 respondents. Only 10 respondents
(29%) reported having previously used any technology that enables the remote operation
of medical imaging equipment before the demonstration at the conference.
Fig. 1 Demographic information (percentages) of respondents (N = 35).
According to [Fig. 2 ], respondents generally express mixed opinions about the remote MR scanning technology.
While they acknowledge its ease of use and usefulness, there is hesitation regarding
adoption and enjoyment. A significant number of neutral responses appear across various
statements, indicating a need for better engagement and improvements in user experience
and support.
Fig. 2 Distribution (percentages) of responses (N = 35).
A summary of the mean scores and standard deviations for each statement in the TAM
is presented in [Table 1 ].
Table 1
Descriptive statistics (N = 35)
Section
Statement
Mean
SD
PEoU
1.1 Learning to operate the technology was easy for me
4.49
0.70
1.2 I find it easy to get technology to do what I want it to do
4.11
0.76
1.3 My interaction with the technology is clear and understandable
4.09
0.78
1.4 My interaction with the technology does not require significant mental effort
3.00
1.28
1.5 It would be easy for me to become skillful at using the technology
4.31
0.83
1.6 Overall, I find it easy to use such technologies
3.80
0.90
Average score
3.97
0.65
PU
2.1.Using the technology would enable me to accomplish my tasks more quickly
3.80
1.05
2.2 Using the technology would improve my job performance
3.80
1.05
2.3 Using the technology would increase my productivity
3.94
0.97
2.4 Using the technology would enhance my effectiveness on the job
3.80
1.11
2.5 Using the technology would make it easier to do my job
3.97
0.89
2.6 Overall, I would find the technology useful in my job
4.09
1.12
Average score
3.90
0.88
ATT
3.1 Using the technology is advisable in clinical practice
3.37
1.09
3.2 Using the technology is a pleasant idea
3.69
1.25
3.3 I will enjoy using the technology
3.46
1.37
3.4 I will be satisfied using the technology
3.80
1.26
Average score
3.58
1.05
BI
4.1 I predict that I will use the technology in the future
3.63
1.14
4.2 The technology will be one of my favorite technologies for my work
3.49
1.20
4.3 I intent to use the technology in my work
3.89
0.99
Average score
3.67
0.98
Abbreviations: ATT, attitude toward technology; BI, behavioral intention to use the
technology; PEoU, perceived ease of use; PU, perceived usefulness; SD, standard deviation.
The results on PEoU indicate that respondents generally find the system easy to use,
but some experience cognitive effort when interacting with it. While respondents believe
that the system is useful for their work, they have slightly lower confidence in the
system's capacity to enhance effectiveness (PU). Regarding ATT, respondents have a
moderate attitude toward using the system, but uncertainty exists about whether it
is advisable in clinical practice. Moreover, the results on BI indicate that respondents
have a moderate intention to use the system, but it is not necessarily a favorite
technology.
The correlation coefficients (r ) are shown in [Table 2 ].
Table 2
Correlation test results between variables
PEoU
PU
ATT
BI
PEoU
1.00
0.44[a ] (p = 0.008)
0.52[b ] (p = 0.001)
0.40[a ] (p = 0.018)
PU
0.44[a ] (p = 0.008)
1.00
0.89[a ] (p < 0.001)
0.62[a ] (p < 0.001)
ATT
0.52[b ] (p = 0.001)
0.89[a ] (p < 0.001)
1.00
0.75[a ] (p < 0.001)
BI
0.40[a ] (p = 0.018)
0.62[a ] (p < 0.001)
0.75[a ] (p < 0.001)
1.00
Abbreviations: ATT, attitude toward technology; BI, behavioral intention to use the
technology; PEoU, perceived ease of use; PU, perceived usefulness.
a Spearman's correlation.
b Pearson's correlation.
A significant positive relation is observed between PU and ATT, and ATT and BI, indicating
that respondents who find the system useful have a more positive attitude toward it,
and that a more positive attitude strongly predicts intention to use, respectively.
PU significantly influences BI, as reflected by the significant relation between these
two variables. Moderate relations between PEoU and ATT, PEoU and PU, and PEoU and
BI indicate that PEoU moderately affects ATT, has a moderate effect on PU, and has
the weakest but still significant impact on BI. Briefly, PU is a strong predictor
of ATT and BI, meaning respondents who see the system as useful are more likely to
have a positive attitude and intend to use it. ATT is the strongest predictor of BI,
suggesting that fostering a positive attitude significantly increases adoption.
Radiographers' responses to the open-ended question, “Please share your opinions or
concerns regarding the practicality of remote MR scanning technology, workflow management,
human resources, and professional issues,” are summarized in [Table 3 ].
Table 3
Benefits, concerns, and considerations summarized from open responses
Benefits
Training and support
Remote MRI scanning can be used to train new and support less-experienced radiographers/technologists
when performing advanced imaging protocols
Access to MRI services for residents of islands, remote, and rural areas
This technology can be utilized in islands, remote and rural areas with a shortage
of skilled radiographers/technologists, to improve accessibility in MRI services
Operational efficiency
Skilled radiographers/technologists can serve as supervisors, enhancing imaging quality
when supporting less-experienced colleagues and performing imaging and protocol quality
controls remotely
Working flexibility
Working from home or remotely can be both productive and practical, especially in
cases of illness or workforce shortages
Workflow management
This technology has the potential to support radiographers/technologists to complete
advanced examinations and manage workloads more efficiently
Sharing good practices
This technology may contribute to the improvement and standardization of imaging techniques
and services
Concerns
Loss of the radiographer/technologist's physical presence
The radiographer/technologist's potential absence from the MRI area could impact the
quality of the imaging process
Patient safety
Concerns are raised about proper patient positioning, monitoring of multiple patients,
and management of potential adverse events without the physical presence of skilled
and authorized personnel
Technical issues
Issues such as internet connection speed, stability, and capacity; image access delay;
and possible system outages can affect complex examinations and patient experience
negatively
Risk of job losses
There is significant concern that this technology may reduce radiographer/technologist
available job vacancies, leading to unemployment
Downgrading of the radiographer/technologist's role
Concerns are expressed about controverting the role of radiographers/technologists
in the MRI workstation and underestimating their professional contributions
Social isolation
If a radiographer/technologist primarily works remotely, their interaction with colleagues
and patients may be limited, which can negatively impact on their professional experience
and development
Training and skills development
Effective use of this technology necessitates training, language proficiency, and
computer skills, which can pose challenges for some professionals
Regulatory and ethical issues
Questions arise regarding legislation, regulations, responsibilities, accountability,
safety, and cybersecurity related to the implementation of this technology
Considerations
Remote MRI scanning should be used to complement the work of radiographers/technologists
who are physically present when needed, rather than replace them
High-speed and stable internet connection and dedicated equipment and software are
imperative for reliable remote MRI scanning
Remote MRI scanning should be used for training and support when performing advanced
examinations
Protective measures should be implemented to safeguard radiographers/technologists'
employment and job vacancies
The pilot implementation of remote MRI scanning is necessary to evaluate the real
benefits and problems that may arise
The remote and local radiographer/technologist should collaborate effectively to ensure
patient safety, communication and monitoring, and optimal examinations
Radiographers/technologists must receive appropriate, timely, and ongoing training
in all aspects of remote MRI scanning to fully leverage those new capabilities
Abbreviation: MRI, magnetic resonance imaging.
Discussion
To the best of our knowledge, this is the first attempt to explore the acceptance
of remote MR scanning in Greece. Yet, remote MR scanning technology is not a new concept.[3 ]
[8 ]
[9 ]
[10 ] An evaluation of this technology among 11 MRI radiographers in the United Kingdom
has revealed a high mean PEoU score, indicating that respondents generally found the
system easy to use. PU had a lower mean score, which might suggest that while the
system was easy to use, its practical benefits were not as strongly perceived. ATT
and BI were found to be moderate, suggesting that respondents feel relatively neutral
about the technology; hence, while some respondents may continue using the system,
others remain unsure.[11 ] In our survey, PEoU and PU are relatively high, indicating that respondents find
the system easy to use and useful. ATT and BI are slightly lower, suggesting some
hesitation in adoption. Our survey has concluded that PU is strongly related to ATT,
meaning that the respondents with a higher perception of the system's usefulness have
a more positive attitude toward its use.
Remote MRI scanning technology has the potential to maintain or even enhance the quality
of patient care, particularly in underserved or rural areas where access to experienced
MRI radiographers is limited.[12 ]
[13 ] However, ensuring quality patient care depends on robust MRI protocols, real-time
collaboration, and reliable system and internet connection performance.[14 ]
[15 ] In emergencies, the facility must have appropriately trained on-site personnel to
respond promptly, as the remote radiographer may not be able to intervene physically.
Clear emergency protocols and staff training are therefore critical for patient safety.[5 ]
[16 ] During a remote MRI scan, patient positioning typically falls under the responsibility
of an on-site radiographer who is trained in MRI safety and positioning, while the
remote MRI radiographer can guide the process via video or audio communication.[17 ] Therefore, effective collaboration between remote and on-site radiographers and
adequate training are key factors to ensure patient safety, seamless communication,
and optimal examination quality for this model.
Our findings show that the respondents find the technology both easy to use and useful,
but with some hesitation in adoption. Overall, the respondents have mixed opinions
about their attitude toward technology and whether they will use it. The limitation
of this survey was the small sample size. Moreover, most respondents did not fully
interact with this technology before the demonstration at the conference. Consequently,
the findings are not widely applicable. Continuous monitoring and evaluation of larger
sample sizes will provide more reliable results once the technology is widely adopted
in practice.
