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  1. Ibrahim, M. I., Mohd Norsuddin, N., Che Isa, I. N., Azman, N. F., Mohamad Shahimin, M.
    MyJurnal
    The radiographer's role in the imaging field is producing the best image to diagnose. Hence, this study is conducted to justify the ability of radiographers in terms of diagnostic performance and visual search patterns during radiographic image interpretation based on their experience. The musculoskeletal radiographic images were chosen as radiographers are expected to perform image interpretation in the red dot system as one of the expanded and extended roles of the radiographer. Sensitivity and specificity in the detection of abnormality are measured. The gaze plot, fixation count and duration are compared between groups of radiographers by using an eye tracker. 19 radiographic images consist of upper and lower extremities are used as stimuli in this study. The result from this study shows no significant difference in terms of sensitivity and specificity with a p-value of 0.818 and 0.146 respectively. For visual search pattern, two images have significant different in term of fixation count (Image 1, p = 0.017; Image 2, p = 0.042) and two images in fixation duration (Image 1, p = 0.001; Image 15, p = 0.021). The gaze plot is not different from an unstructured pattern and less coverage. In conclusion, the experience did not give an influence on the radiographic image interpretation. This may suggest that specific training in areas appropriate to the development of the radiographer could improve the image interpretation.
  2. Mohd Zain, N., Ab Malek, N. N. F., Che Mut, N. A. I., Mohd Norsuddin, N., Abdullah Suhaimi, S. A., Ahmad Dahari, M., et al.
    MyJurnal
    Music is one of the suggested interventions that can reduce stress caused by pain from mammography procedures. The different types of music might affect the anxiety level during a mammogram screening. Thus, the study aimed to determine the anxiety level of women who underwent mammogram screening according to different types of music. A cross-sectional study was conducted on 60 women by using the purposive sampling technique in the radiology department at randomly selected private hospitals in Klang Valley from November 2018 to November 2019. Respondents were randomly divided based on the day of mammogram screening into two groups; namely slow and upbeat music. Descriptive analysis was used to determine the anxiety level for each group and T-test analysis was used to compare the significance of anxiety level between both groups. A total of 60 respondents had participated in this study with a total of 30 (50.0%) respondents allocated in slow music, while another 30 (50.0%) respondents were allocated in upbeat music. Patients who underwent mammography screening while listening to slow music had a high anxiety level (70.0%) as compared to upbeat music group (63.3%). There was no significant effect for music, t (60) = -0.54, p = 0.59, despite slow music (M = 1.70, SD = 0.47) attaining higher anxiety level than the upbeat music (M = 1.63, SD = 0.49). Upbeat music has the potential in reducing the anxiety level of women undergoing mammography screening.
  3. Mohd Norsuddin N, Mello-Thoms C, Reed W, Lewis S
    Asian Pac J Cancer Prev, 2019 Feb 26;20(2):537-543.
    PMID: 30803217
    Rationale and objectives: Target recall rates are often used as a performance indicator in mammography screening
    programs with the intention of reducing false positive decisions, over diagnosis and anxiety for participants. However,
    the relationship between target recall rates and cancer detection is unclear, especially when readers are directed to
    adhere to a predetermined rate. The purpose of this study was to explore the effect of setting different recall rates on
    radiologist’s performance. Materials and Methods: Institutional ethics approval was granted and informed consent
    was obtained from each participating radiologist. Five experienced breast imaging radiologists read a single test set
    of 200 mammographic cases (20 abnormal and 180 normal). The radiologists were asked to identify each case that
    they required to be recalled in three different recall conditions; free recall, 15% and 10% and mark the location of any
    suspicious lesions. Results: Wide variability in recall rates was observed when reading at free recall, ranging from
    18.5% to 34.0%. Readers demonstrated significantly reduced performance when reading at prescribed recall rates,
    with lower sensitivity (H=12.891, P=0.002), case location sensitivity (H=12.512, P=0.002) and ROC AUC (H=11.601,
    P=0.003) albeit with an increased specificity (H=12.704, P=0.002). However, no significant changes were evident in
    lesion location sensitivity (H=1.982, P=0.371) and JAFROC FOM (H=1.820, P=0.403). Conclusion: In this laboratory
    study, reducing the number of recalled cases to 10% significantly reduced radiologists’ performance with lower detection
    sensitivity, although a significant improvement in specificity was observed.
  4. Teoh KC, Manan HA, Mohd Norsuddin N, Rizuana IH
    Healthcare (Basel), 2021 Dec 19;9(12).
    PMID: 34946484 DOI: 10.3390/healthcare9121758
    Early detection of breast cancer is diagnosed using mammography, the gold standard in breast screening. However, its increased use also provokes radiation-induced breast malignancy. Thus, monitoring and regulating the mean glandular dose (MGD) is essential. The purpose of this study was to determine MGD for full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in the radiology department of a single centre. We also analysed the exposure factors as a function of breast thickness. A total of 436 patients underwent both FFDM and DBT. MGD was auto calculated by the mammographic machine for each projection. Patients' data included compressed breast thickness (CBT), peak kilovoltage (kVp), milliampere-seconds (mAs) and MGD (mGy). Result analysis showed that there is a significant difference in MGD between the two systems, namely FFDM and DBT. However, the MGD values in our centre were comparable to other centres, as well as the European guideline (<2.5 mGy) for a standard breast. Although DBT improves the clinical outcome and quality of diagnosis, the risk of radiation-induced carcinogenesis should not be neglected. Regular quality control testing on mammography equipment must be performed for dose monitoring in women following a screening mammography in the future.
  5. Abdulwahid Mohammad Noor K, Mohd Norsuddin N, Che Isa IN, Abdul Karim MK
    Radiography (Lond), 2024 Jul;30(4):1041-1052.
    PMID: 38723445 DOI: 10.1016/j.radi.2024.04.019
    INTRODUCTION: Breast imaging plays a crucial role in the early detection and management of breast cancer, with visual quality, modality innovation and diagnostic performance being key factors in achieving accurate diagnoses and optimal patient outcomes. This paper presents a comprehensive bibliometric analysis of the literature on the three above elements focusing on breast imaging, aiming to uncover publication trends, identify influential works and authors, and highlight future research directions.

    METHODS: We employed a methodical bibliometric approach, making use of Scopus and Web of Science (WoS) databases for gathering literatures. We planned our search strategy, concentrating on terms linked to "breast imaging," "image quality," and "diagnostic accuracy" to ensure a systematic examination of the subject. The enhanced search functions in these databases enabled us to narrow down and improve our findings, choosing only the articles, conference papers, and book sections that are most relevant. After conducting a thorough screening process to remove duplicates and evaluate significance, we utilized ScientoPy and VOSviewer software for an in-depth bibliometric analysis. This helped to explore trends in publications, patterns of citations, and thematic groups, giving us a better understanding of how the field has changed and where it currently stands. Our approach prioritized assessing methodological quality and bias in the studies we included, guaranteeing the reliability of our findings.

    RESULTS: We reviewed 2984 relevant publications, revealing a consistent annual growth rate of 2.8% in breast imaging research, with the United States and Europe leading in contributions. The study found that advancements in radiological technologies and international collaboration are driving forces behind the field's expansion. Key subject areas such as 'Radiology, Nuclear Medicine, and Medical Imaging' dominated, underscoring their impact on diagnostic quality. Notable authors and institutions have been identified for their influential research, characterized by high citation metrics and significant scholarly impact.

    CONCLUSION: The study shows a continuous increase in research on breast imaging, considered by new technologies and teamwork defining the present time. The assessment highlights a key move towards utilizing digital imaging methods and computational analysis, affecting the improvement of future diagnostic procedures and patients' results. The study highlights the importance of continued international collaborations to tackle the new barriers in breast imaging and make the most of technological progress.

    IMPLICATIONS FOR PRACTICE: This study shows a focus on using interdisciplinary methods and cutting-edge technology in breast imaging to help healthcare professionals improve their performance and accuracy in diagnosis. Recognizing vital research and emerging trends should guide clinical guidelines, radiology training, and patient care plans to encourage the use of effective techniques and stimulate innovation in diagnostic approaches.

  6. Mohd Norsuddin N, Mello-Thoms C, Reed W, Rickard M, Lewis S
    Br J Radiol, 2017 Aug;90(1076):20170048.
    PMID: 28621548 DOI: 10.1259/bjr.20170048
    OBJECTIVE: This study investigated whether certain mammographic appearances of breast cancer are missed when radiologists read at lower recall rates.

    METHODS: 5 radiologists read 1 identical test set of 200 mammographic (180 normal cases and 20 abnormal cases) 3 times and were requested to adhere to 3 different recall rate conditions: free recall, 15% and 10%. The radiologists were asked to mark the locations of suspicious lesions and provide a confidence rating for each decision. An independent expert radiologist identified the various types of cancers in the test set, including the presence of calcifications and the lesion location, including specific mammographic density.

    RESULTS: Radiologists demonstrated lower sensitivity and receiver operating characteristic area under the curve for non-specific density/asymmetric density (H = 6.27, p = 0.04 and H = 7.35, p = 0.03, respectively) and mixed features (H = 9.97, p = 0.01 and H = 6.50, p = 0.04, respectively) when reading at 15% and 10% recall rates. No significant change was observed on cancer characterized with stellate masses (H = 3.43, p = 0.18 and H = 1.23, p = 0.54, respectively) and architectural distortion (H = 0.00, p = 1.00 and H = 2.00, p = 0.37, respectively). Across all recall conditions, stellate masses were likely to be recalled (90.0%), whereas non-specific densities were likely to be missed (45.6%).

    CONCLUSION: Cancers with a stellate mass were more easily detected and were more likely to continue to be recalled, even at lower recall rates. Cancers with non-specific density and mixed features were most likely to be missed at reduced recall rates. Advances in knowledge: Internationally, recall rates vary within screening mammography programs considerably, with a range between 1% and 15%, and very little is known about the type of breast cancer appearances found when radiologists interpret screening mammograms at these various recall rates. Therefore, understanding the lesion types and the mammographic appearances of breast cancers that are affected by readers' recall decisions should be investigated.

  7. Ravintaran T, Go KX, Che Isa IN, Mohd Norsuddin N, Sabarudin A, Mohamed Sharif N, et al.
    Heliyon, 2023 Jan;9(1):e12773.
    PMID: 36685374 DOI: 10.1016/j.heliyon.2022.e12773
    BACKGROUND: Lack of public understanding, perception and awareness of the biological effects of prenatal ultrasound has led to the non-medical use of ultrasound. An educational programme is required to enlighten pregnant women and the public regarding prenatal ultrasound safety.

    OBJECTIVE: To evaluate the effectiveness of educational modules (video and brochure) in improving knowledge, awareness and perception (KAP) among pregnant women regarding prenatal ultrasound safety.

    METHODS: This is a quasi-experimental study with a pre-and post-test design. This study recruited 51 pregnant women as respondents from the Obstetrics and Gynaecology clinic (O&G) of Hospital Canselor Tuanku Muhriz (HCTM). The first phase of the study was conducted by distributing a set of closed-ended questionnaires with multiple choice and Likert scale answers to assess the KAP of pregnant women regarding the safe use of prenatal ultrasound, followed by educational modules where the respondents were allocated into three groups (17 watched a video, 17 received brochure and 17 received combined media). After the intervention, the respondents' KAP were assessed using the same questionnaire.

    RESULTS: The Wilcoxon signed rank test showed that educational modules like video, brochure and combined media had a statistically significant increase in post-test scores over the pre-test scores (video: mean rank = 9.00, p  0.05). The Kruskal Wallis test indicated that educational video was more effective in improving the KAP of pregnant women than the brochure and combined media (mean rank = 34.62, p 

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