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A research report submitted to the Faculty of Health Sciences, University of the of Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in Diagnostic Radiology.

CITATION: Davis, R. 2015. The South African Journal of Radiology growing in leaps and bounds. South African Journal of Radiology, 19(1), Art. #956, doi:10.4102/sajr.v19i1.956.

Background: Radiology is rapidly advancing, with a global transition to digital imaging technology to improve productivity and enhance communication. The major challenge confronting radiology practices is to demonstrate cost savings and productivity gains when a picture archiving and communication system (PACS) is established.Aim: To undertake an incremental cost analysis of PACS compared with conventional radiology to determine productivity gains, if any, at two private hospitals in Durban.Method: An incremental cost analysis for chest radiographs, computed tomography and magnetic resonance imaging brain scans with and without contrast were performed. The overall incremental cost for PACS in comparison with a conventional radiology site was determined. The net present value was also determined to evaluate the capital budgeting requirements for both systems.Results: The incremental cost of both capital and the radiology information system for installing PACS shows an expected increase. The incremental PACS image cost shows a reduction.Conclusion: The study provides a benchmark for the cost incurred when implementing PACS. It also provides a decision framework for radiology departments that plan to introduce PACS and helps to determine the feasibility of its introduction.

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Musculoskeletal radiology in South Africa has shown significant growth in the last decade. This was achieved through advanced educational programmes, international input and significantly improved imaging techniques and equipment - which in turn has enabled musculoskeletal (MSK) radiologists to offer an improved service to referring physicians.

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The endeavors of my predecessor, Professor Jan Lotz, a committed visionary who served the South African Journal of Radiology (SAJR) in a permanent capacity for 5 years (2008 - 2012), are gratefully acknowledged. Under his stewardship, the SAJR benefited from a consistent editorial policy. The journal grew in size to an average of 40 pages per issue, with broader editorial variety accordingly. The online manuscript management system revolutionised the submission and review process. The promised CPD programme was delivered and the journal took major steps toward international recognition, being invited to join GO RAD (Global Outreach - Radiology), a global outreach programme of the International Society of Radiology.

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The South African Journal of Radiology reports below a South African 'first' : the award of the Frank Doyle Medal to Dr Pieter Janse van Rensburg by the Royal College of Radiologists for being the highest-scoring candidate in the autumn 2009 part A final examination.

Portal Hypertension can be successfully managed using a variety of interventional radiology techniques. The presinusoidal, sinusdoidal and post sinusoidal categories have different options available, as does segmental portal hypertension. The major role of TIPS has been tempered by early occlusions and high rates of hepatic encephalopathy .

Vascular laboratories play an increasing part in treating patients via intravascular procedures. The diagnostic purpose of vascular laboratories is being somewhat diminished by excellent diagnostic imaging machines like the 64-slice CT scanner and three Tesla MRI scanners. Thus, the emphasis falls on treating patients using intravascular procedures rather than performing diagnostic procedures. When planning a vascular laboratory it should be kept in mind that the main purpose of such a laboratory is to treat patients using various interventional skills. Planning a vascular laboratory depends on various factors like the geographic environment of the radiology practice, the need for interventional procedures, types of angiography procedures, the number of patients, building size, and lastly the budget available for equipment and running costs. Usually the suppliers of the angio-equipment will play an integral part in planning and developing a catheterisation laboratory. Some of the practical planning aspects are discussed in this article. South African Journal of Radiology Vol. 10 (2) 2006: pp. 13-14

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This article was first published in the August 2013 issue of Continuing Medical Education (Vol. 31, Issue 8), and is reproduced here because of its topicality and desirability of reaching a broader audience.

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GO RAD

Bob Bury, the editor of Clinical Radiology, has kindly written an accompanying editorial for this issue of the South African Journal of Radiology. To place his piece in context, one has to at least have paged through the special June 2010 edition of Clinical Radiology on molecular imaging (MI). The introductory article explains the role of small molecules in the form of peptides or antibodies that are linked to an imaging label and are destined to attach to a tumour antigen. In the case of PET and SPECT, the labels are radioactive substances. RSSA President Clive Sperryn's thoughts on MI appear in this SAJR's Radioactive News section.

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To the Editor : I find the letter by Professor van Niekerk which was published in the June 2010 edition of the South African Journal of Radiology most interesting. He stated that it was acceptable for specialists such as cardiologists to use ionising radiation for imaging in their practices, but went on to mention 'the proliferation of many diagnostic and therapeutic interventions that are reliant on expensive equipment'. Professor van Niekerk replies : Thank you for your response. The HPCSA policy is that doctors may practise in fields in which they have had adequate training. If training is perceived to be inadequate, it is up to the person(s)/group believing it to be so to persuade those who are responsible for regulation and for education to address this. It was in response to the inadequacy of the training of general practitioners who owned X-ray equipment that the committee was established.

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Extracted from text ... 2 SA JOURNAL OF RADIOLOGY ? December 2005 EDITORIAL Bounding ahead with our Journal Savvas Andronikou MB BCh, FCRad (SA), FRCR (Lond), PhD (UCT) Department of Radiology Tygerberg Hospital University of Stellenbosch This will read more like a memo than an editorial but I guess this is the best avenue for informing our readers.We must extend our gratitude as a Society and as a professional body to Ian Duncan who served this journal as chief editor and brought it alive. I see Ian is still active in publishing, with a current paper in Paediatric Radiology. Keep up the good ..

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2 SA JOURNAL OF RADIOLOGY • October 2004 The South African Journal of Radiology is now coming of age. With the appointment of an Editor-in-Chief, the creation of a new academic editorial board and the use of a more formalised peer-review system for all submissions, the journal is set to raise its profile among other radiological publications. With the implementation of the above changes we will eventually attempt to have the journal indexed internationally, thereby transforming it into the more substantial publication that South African radiology deserves. Our standards of training and practice are high and there is good demand for our expertise — let our journal in turn reflect this. Many thanks go to Professor J P van Niekerk for his encouragement and support in making this transition and for facilitating our growth. Coming of age

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