Lecture 1 - Basics of Radiological Imaging PDF

Lecture 1 Fundamentals of Radiological Imaging Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo University 1 1. Introduction to Radiological Technology Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo...

Lecture 1 Fundamentals of Radiological Imaging Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo University 1 1. Introduction to Radiological Technology Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 2 University Importance of Radiology in Physiotherapy Aids in diagnosis and treatment planning Helps monitor progress and evaluate treatment effectiveness Enables better communication with other healthcare professionals Improves patient education and understanding of their condition Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 3 University Basic Principles of X-ray Production X-rays are a form of electromagnetic radiation X-rays penetrate tissues differently based on density Denser tissues (like bone) appear white on X-ray images Less dense tissues (like air in lungs) appear black Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 4 University Radiation Safety Basics ALARA principle: As Low As Reasonably Achievable Physiotherapist's role in radiation safety: Awareness of radiation risks Appropriate referral for imaging Patient education on radiation safety Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 5 University X-ray Imaging Oldest and most common form of medical imaging Uses ionizing radiation to produce images Advantages: Quick, widely available, relatively inexpensive Limitations: Limited soft tissue visualization, radiation exposure Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 6 University X-ray Imaging Applications in physiotherapy: Diagnosing fractures and dislocations Assessing joint alignment Detecting arthritis progression Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 7 University X-ray Imaging Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 8 University Computed Tomography (CT) Uses multiple X-ray images to create cross-sectional views Produces detailed images of both bone and soft tissue Advantages: Detailed 3D reconstructions possible Fast scanning Limitations: Higher radiation dose than conventional X-ray Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 9 University  Computed Tomography (CT) Applications in physiotherapy: Evaluating complex fractures Assessing spinal conditions (herniated discs, stenosis) Detecting subtle bone lesions Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 10 University Computed Tomography (CT) Applications in physiotherapy: Evaluating complex fractures Assessing spinal conditions (herniated discs, stenosis) Detecting subtle bone lesions Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 11 University Computed Tomography (CT) Applications in physiotherapy: Evaluating complex fractures Assessing spinal conditions (herniated discs, stenosis) Detecting subtle bone lesions Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 12 University Magnetic Resonance Imaging (MRI) Uses strong magnetic fields and radio waves Excellent for soft tissue imaging No ionizing radiation Advantages: Superior soft tissue contrast No radiation Limitations: Longer scan times contraindicated with certain metal implants Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo University 13 Magnetic Resonance Imaging (MRI) Applications in physiotherapy: Diagnosing soft tissue injuries (muscles, tendons, ligaments) Evaluating joint conditions (meniscal tears, cartilage damage) Assessing nerve compression and spinal cord issues Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 14 University  Magnetic Resonance Imaging (MRI) Applications in physiotherapy: Diagnosing soft tissue injuries (muscles, tendons, ligaments) Evaluating joint conditions (meniscal tears, cartilage damage) Assessing nerve compression and spinal cord issues Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 15 University  Magnetic Resonance Imaging (MRI) Applications in physiotherapy: Diagnosing soft tissue injuries (muscles, tendons, ligaments) Evaluating joint conditions (meniscal tears, cartilage damage) Assessing nerve compression and spinal cord issues Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 16 University  Ultrasound Uses sound waves to produce images Real-time imaging capability No ionizing radiation Advantages: Portable Real-time imaging Can assess tissue during movement Limitations: Operator-dependent limited depth penetration Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 17 University  Ultrasound Applications in physiotherapy: Assessing muscle and tendon injuries Evaluating joint effusions and bursitis Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 18 University Nuclear Medicine Uses small amounts of radioactive materials (tracers) Provides functional information about tissues and organs Advantages: Can detect problems before structural changes occur Limitations: Lower spatial resolution Radiation exposure Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 19 University Nuclear Medicine Applications in physiotherapy: Bone scans for stress fractures or metastases Assessing blood flow in extremities Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 20 University Nuclear Medicine Applications in physiotherapy: Bone scans for stress fractures or metastases Assessing blood flow Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 21 University  Summary Common Physiotherapy Modality Key Principle Best For Applications Fractures, joint alignment, X-ray Ionizing radiation Bone imaging arthritis Complex fractures, spinal CT Multiple X-rays, cross-sectional Bone and soft tissue conditions Muscle/tendon injuries, joint MRI Magnetic fields and radio waves Soft tissue imaging conditions Muscle/tendon injuries, Ultrasound High-frequency sound waves Superficial soft tissue guided interventions Stress fractures, blood flow Nuclear Medicine Radioactive tracers Functional imaging Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo assessment22 University 2. Image Production Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 23 University  A. Film/Screen Radiography Traditional method using X-ray sensitive film Components: X-ray tube Film cassette with intensifying screens X-ray film Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 24 University  Radiographic Quality 1. kVp (kilovoltage peak): Controls X-ray penetration and contrast Higher kVp = more penetration, less contrast 2. mAs (milliampere-seconds): Controls quantity of X-rays Higher mAs = more radiation, increased density 3. Source-to-Image Distance (SID): Affects image magnification and sharpness 4. Patient positioning: Crucial for accurate representation of anatomy Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 25 University  Image characteristics Density: Overall darkness of the image Contrast: Difference between light and dark areas Sharpness: Clarity of structural edges Distortion: Accuracy of size and shape Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 26 University  B. Fluoroscopic Imaging Real-time X-ray imaging Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 27 University  C. Digital Imaging 1.Computed Radiography (CR) Uses phosphor plates instead of film Plates are scanned to produce digital image 2.Digital Radiography (DR) Direct conversion of X-rays to digital signals Flat-panel detectors: Direct or indirect conversion Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 28 University  Image Production Methods Summary Method Key Features Advantages Disadvantages Chemical processing, storage Film/Screen Uses X-ray sensitive film Widely available, familiar issues Useful for motion studies, Higher radiation dose, Fluoroscopy Real-time imaging immediate feedback limited resolution Fast, lower dose, Digital (CR/DR) Electronic image capture Initial cost of equipment manipulable, easy storage Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 29 University 3. Professional Ethics in Radiology Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 30 University Patient Safety and Radiation Protection ALARA principle: As Low As Reasonably Achievable Minimize exposure time Maximize distance from source Use appropriate shielding Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 31 University Patient Privacy and Confidentiality Proper handling of radiological images and reports Secure storage of digital images Controlled access to patient information Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 32 University  Informed Consent Explaining procedures and risks to patients Physiotherapist's role: Educating patients about imaging procedures Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 33 University Practice Questions Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 34 University Practice Questions 1. Which of the following imaging modalities uses strong magnetic fields and radio waves to produce images? a) X-ray b) CT c) MRI d) Ultrasound Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 35 University Practice Questions 2. The ALARA principle in radiation safety stands for: a) As Long As Radiation Allows b) As Low As Reasonably Achievable c) Always Limit Anterior Radiation Angle d) All Levels Are Radiation Acceptable Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 36 University Practice Questions 3. In X-ray imaging, which of the following tissues would appear white on the image? a) Lung tissue b) Bone c) Muscle d) Fat Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 37 University Practice Questions 4. Which imaging modality is best suited for evaluating soft tissue injuries such as muscle tears or ligament sprains? a) X-ray b) CT c) MRI d) Nuclear Medicine Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 38 University Practice Questions 5. In radiographic quality, what does kVp control? a) Image density b) X-ray quantity c) X-ray penetration and contrast d) Image sharpness Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 39 University Practice Questions 6. Which imaging modality uses small amounts of radioactive materials (tracers) to provide functional information about tissues and organs? a) X-ray b) CT c) Ultrasound d) Nuclear Medicine Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 40 University Practice Questions 7. What is the main advantage of digital imaging over traditional film/screen radiography? a) Higher radiation dose b) Faster image acquisition and easy storage c) Better image quality d) Lower equipment cost Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 41 University Practice Questions 8. Which of the following is NOT a component of informed consent for imaging procedures? a) Nature of the procedure b) Risks and benefits c) Alternatives d) Guarantee of positive outcomes Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 42 University Practice Questions 9. In CT imaging, what does CT stand for? a) Computerized Tomography b) Contrast Technology c) Cellular Tissue d) Cortical Thickness Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 43 University Practice Questions 10. Which of the following imaging modalities does NOT use ionizing radiation? a) X-ray b) CT scan c) Ultrasound d) Nuclear medicine Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 44 University Answers Question Answer 1 c 2 b 3 b 4 c 5 c 6 d 7 b 8 d 9 a 10 c Dr. Omnia Mokhtar Nada, Professor of Radiology at Cairo 45 University