Introduction to Radiography & Medical Imaging PDF

Stay Home-Stay Safe Introduction to Radiography & Medical Imaging Introduction to Radiography & Medical Imaging Slide 1 fchs.ac.ae Content Medical Imaging Organization 1. Historical Background 2. Professional personnel 3. Support personnel 4. Patient Services fchs.ac.ae Objective Understand the hist...

Stay Home-Stay Safe Introduction to Radiography & Medical Imaging Introduction to Radiography & Medical Imaging Slide 1 fchs.ac.ae Content Medical Imaging Organization 1. Historical Background 2. Professional personnel 3. Support personnel 4. Patient Services fchs.ac.ae Objective Understand the history of ionizing radiation Describe the contributions of individuals in the field of medical imaging X-Ray Production fchs.ac.ae Terms Radiology :is the science of radiation. Radiography : is the use of radiation to produce an image. Radiograph : is the image produced using radiation. Radiographer/ X-ray Technician : is professional who is responsible for producing high quality image using X-ray. Radiologist : the physician who practice radiology And diagnoses the images fchs.ac.ae Historical Background fchs.ac.ae Discovery of X-Ray Then, on November 8, 1895, Wilhelm Conrad Roentgen, a German physicist, was working with a Crookes tube at the University of Wurzburg. In his darkened laboratory, he enclosed the tube with black photographic paper so that no light could escape. Across the room, a plate coated with barium platinocyanide crystals, a fluorescent material, began to glow. Roentgen noted that the plate fluoresced in relation to its distance from the tube, becoming brighter when the plate was moved closer. fchs.ac.ae He placed various materials, such as wood, aluminum, and his hand, between the plate and the tube, noting variations in the effect upon the plate. He spent the next few weeks investigating this mysterious energy that he called "x ray," x being the symbol for the unknown. By the end of the year, Roentgen had identified nearly all of the properties of x-rays known today. He was awarded the first Nobel Prize in physics in 1901 in recognition of his discovery. fchs.ac.ae Early Radiographers During his early experimentation with x-rays, Roentgen produced the first anatomic radiograph, an image of his wife's hand. The first radiographers were physicists familiar with the operation of the Crookes tube. As x-ray-generating equipment was installed in hospitals and physicians' offices, physicians learned to take radiographs and soon developed techniques to demonstrate many different anatomic structures. Physicians who used x-rays began to train their assistants to develop the photographic plates and to assist with x-ray examinations. In time, many of these assistants became skilled in radiography. fchs.ac.ae fchs.ac.ae Medical Imaging department The department where you receive your clinical experience in radiography may be called the radiology department. Since the early use of x-rays in medicine, radiology has been the term applied to the science of medical imaging. Because some of the new imaging modalities do not involve the use of x-rays, some radiology departments have been renamed diagnostic imaging departments. fchs.ac.ae Professional personnel & Support personnel fchs.ac.ae Radiology Organization Similar to the organization of hospital, the formal structure radiology department is subset of large organization. It has the same focus on hospital mission to service pt. fchs.ac.ae Typical organizational structure of the medical imaging department. Hospital Administrator Medical Staff Organization Director of Diagnostic Services Diagnostic Imaging Manager Radiologist Chief nuclear technologist Chief Radiotechnologist MRI- CT Supervisor Radiotechnologist Support Personnel fchs.ac.ae Subdepartments of Radiology large department are often divided into Subdepartments or section such as; – Radiography – Ultrasound – Nuclear medicine – Positron emission tomography (PET) , – Computer tomography(CT) – Magnetic resonance Imaging (MRI) – Vascular ultrasound – Interventional radiology – Radiation therapy and oncology fchs.ac.ae Professional Personnel in radiology department Radiologic technology is technical science that deals with x-rays or radioactive substances. Radiologic technologist is general term applied to a person qualified to use x-ray (radiography) or radioactive substances (Nuclear medicine) to produce images of internal parts of the body for interpretation by physician known as radiologist. Radiologist is the physician who read and writing a reported for the images. Radiotherapy technologist fchs.ac.ae A.THE ADMINISTRATIVE STRUCTURE OF THE DEPARTMENT The radiology services in a modern hospital may be divided among several departments under the supervision of a radiology manager, who works with radiologists and the hospital administration to establish policies and budgets for the various imaging departments. He has direct responsibility for operation and organization , which include; staffing, planning, educating, supervising, coordinating, communicating, maintaining safety and minimizing hazards in workplace. fchs.ac.ae The radiology manager may also supervise several groups of employees, such as those in radiography, nuclear medicine, ultrasound, cardiovascular angiography, computed tomography (CT), and magnetic resonance imaging (MRI). Under the manager's direction, groups of employees may be referred to as teams or "quality teams." fchs.ac.ae B.PROFESSIONAL PERSONAL One who's deal with x-ray or radioactive substances for diagnostic or therapeutic purposes in medical is (radiological technologist) Radiologist is one who's reading the images. fchs.ac.ae The Practice Standards for Medical Imaging and Radiation Therapy, Defines: – The clinical practice, – Technical activities, and – Professional responsibilities of imaging and therapeutic professionals. Course: FRD 4061 Medical imaging science and methods 6 (Image Interpretation)Lecture : Emergency Spine Slide 19 fchs.ac.ae C.SUPPORT PERSONNEL Imaging departments also require support staff. Depending on the size of the department and the organization of the hospital, support personnel may include administrative assistants, receptionists, a medical secretary, and transportation service personnel. There may also be an information systems manager with a staff to maintain patient files, image files, and the computerized images organized in PACS. fchs.ac.ae PATIENT SERVICES – Radiography (x-ray imaging) – Fluoroscopy (special investigations) – Ultrasound scan ( abdomen, gynecology, obstetrics, etc. ) – Nuclear medicine (bone scan, lung scan, thyroid scan, etc.) – Positron emission tomography (PET) , – Computer tomography(CT) – Magnetic resonance Imaging (MRI) – Vascular ultrasound – Interventional radiology – Radiation therapy and oncology – Bone density measurement (DXA) fchs.ac.ae fchs.ac.ae X-ray Machine Abdomen X-ray fchs.ac.ae Objectives 1. Define medical imaging term 2. Differentiate between different types of imaging. medical 3. Explain x-ray production. fchs.ac.ae Medical Imaging Modalities Medical imaging is the technique and process used to create images of the human body for clinical purposes (medical procedures seeking to reveal, diagnose or examine disease) or medical science (including the study of normal anatomy and physiology). fchs.ac.ae The various types of radiological procedures may be grouped by the means in which their images are produced: 1. Transmission imaging, 2. Reflection imaging, 3. Emission imaging. fchs.ac.ae Transmission imaging X-rays, CT scans, and fluoroscopy are radiological examinations whose images are produced by transmission. In transmission imaging, a beam of high-energy photons is produced and passed through the body structure being examined. The beam passes very quickly through less dense types of tissue such as watery secretions, blood, and fat, leaving a darkened area on the x-ray film. Muscle and connective tissues (ligaments, tendons, and cartilage) appear gray. Bones will appear white. fchs.ac.ae Reflection imaging Reflection imaging refers to the type of imaging produced by sending high-frequency sounds to the body part or organ being studied. These sound waves "bounce" off of the various types of body tissues and structures at varying speeds, depending on the density of the tissues present. The bounced sound waves are sent to a computer that analyzes the sound waves and produces a visual image of the body part or structure. Ultrasound is an example of reflection imaging. fchs.ac.ae Emission imaging Emission imaging occurs when tiny, nuclear particles or magnetic energy are detected by a scanner and analyzed by computer to produce an image of the body structure or organ being examined. Nuclear medicine studies use emission of nuclear particles from nuclear substances introduced into the body specifically for the examination. Magnetic resonance imaging (MRI) studies, for example, are obtained by using a large magnet to cause changes in the body tissue in order to detect magnetic energy in the body part or structure being examined fchs.ac.ae Types of imaging modalities according to type of radiation : 1- ionizing radiation 2- non-ionizing radiation fchs.ac.ae Routine Radiography Fluoroscopy Mammography Angiography CT-scan fchs.ac.ae Magnetic Resonance Imaging (MRI) fchs.ac.ae Career in Radiology X-Ray Technologist Special Procedures Technologist CT Technologist Radiation Therapist Sonographer Radiology Nurse Nuclear Medicine Technologist Radiology Manager MRI Technologist Systems (PACS) Administer Mammographer fchs.ac.ae SEE YOU NEXT CLASS Slide 34 fchs.ac.ae Stay Home-Stay Safe Introduction to Radiography & Medical Imaging Lecture 2: Physical principles of radiation science Introduction to Radiography & Medical Imaging Slide 1 fchs.ac.ae Radiation fchs.ac.ae Definition of Radiation “Radiation is an energy in the form of electro-magnetic waves or particulate matter, traveling in the air.” fchs.ac.ae Radioactivity: Elements & Atoms Atoms are composed of smaller particles referred to as: – Protons – Neutrons – Electrons fchs.ac.ae Basic Model of a Neutral Atom. Electrons (-) orbiting nucleus of protons (+) and neutrons. Same number of electrons as protons; net charge = 0. Atomic number (number of protons) determines element. Mass number (protons + neutrons) fchs.ac.ae fchs.ac.ae Radioactivity If a nucleus is unstable for any reason, it will emit and absorb particles. There are many types of radiation and they are all pertinent to everyday life and health as well as available nuclear physical applications. fchs.ac.ae Ionization Ionizing radiation is produced by unstable atoms. Unstable atoms differ from stable atoms because they have an excess of energy or mass or both. Unstable atoms are said to be radioactive. In order to reach stability, these atoms give off, or emit, the excess energy or mass. These emissions are called radiation. fchs.ac.ae Types or Products of Ionizing Radiation  neutron  or X-ray fchs.ac.ae Radioactive Atom Ionizing Radiation alpha particle X-ray beta particle gamma ray fchs.ac.ae The electro-magnetic waves vary in their length and frequency along a very wide spectrum. fchs.ac.ae Forms of Electromagnetic Radiation fchs.ac.ae fchs.ac.ae Types of Radiation Radiation is classified into: – Ionizing radiation – Non-ionizing radiation fchs.ac.ae Ionizing Versus Non-ionizing Radiation Ionizing Radiation – Higher energy electromagnetic waves (gamma) or heavy particles (beta and alpha). – High enough energy to pull electron from orbit. Non-ionizing Radiation – Lower energy electromagnetic waves. – Not enough energy to pull electron from orbit, but can excite the electron. fchs.ac.ae Ionizing Radiation X-ray radiation contains more energy than ultraviolet, infrared, radio waves, microwaves or visible light. X-ray radiation has sufficient energy (>30 eV) to cause ionizations. An ionization is a process whereby the radiation removes an outer shell electron from an atom fchs.ac.ae Non-ionizing radiation does not contain sufficient energy (30 eV) to cause ionizations fchs.ac.ae Ionizing Radiation Definition: “ It is a type of radiation that is able to disrupt atoms and molecules on which they pass through, giving rise to ions and free radicals”. fchs.ac.ae Another Definition Ionizing radiation A radiation is said to be ionizing when it has enough energy to eject one or more electrons from the atoms or molecules in the irradiated medium. This is the case of a and b radiations, as well as of electromagnetic radiations such as gamma radiations, X-rays and some ultra-violet rays. Visible or infrared light are not, nor are microwaves or radio waves. fchs.ac.ae Primary Types of Ionizing Radiation Alpha particles Beta particles Gamma rays (or photons) X-Rays (or photons) Neutrons fchs.ac.ae Types and Characteristics of Ionizing Radiation Alpha Particles: 2 neutrons and 2 protons They travel short distances, have large mass Only a hazard when inhaled to realse stable radioactive fchs.ac.ae Beta Particles Beta Particles: Electrons or positrons having small mass and variable energy. Electrons form when a neutron transforms into a proton and an electron or: poistrons when proton transform to nuetrons and poistrons fchs.ac.ae Gamma Rays Gamma Rays (or photons): Result when the nucleus releases energy, usually after an alpha, beta or positron transition fchs.ac.ae X-Rays X-Rays: Occur whenever an inner shell orbital electron is removed and rearrangement of the atomic electrons results with the release of the elements characteristic X-Ray energy fchs.ac.ae X- and Gamma Rays: X-rays are photons (Electromagnetic radiations) emitted from electron orbits. Gamma rays are photons emitted from the nucleus, often as part of radioactive decay. Gamma rays typically have higher energy (Mev's) than X-rays (KeV's), but both are unlimited. fchs.ac.ae Neutrons Neutrons: Have the same mass as protons but are uncharged fchs.ac.ae X-RAY PRODUCTION fchs.ac.ae X-RAY TUBE The X-ray tube is an evacuated glass cylinder containing cathode and anode. The cathode is heated and emits electrons. The high voltage between cathode and anode accelerates the electrons towards the anode. The high energy electrons collide with the anode and interact with the anode material by creating the typical radiation of the anode element ( W: tungsten) fchs.ac.ae fchs.ac.ae X-ray Machine Parameters ‫كم مقدار االشعه طالعه‬ The quantity of electron flow (current) in the X-ray tube is described in units of milliamperes (mA). The rate of X-ray production is directly proportional to the X-ray tube current. The voltage (kVp) primarily determines the maximum Xray energy (quality) produced but also influences the number of X-rays produced. Total number of X-rays produced at a set kVp depends directly on the product of the mA and exposure time and is typically described in terms of mAs. fchs.ac.ae X-Ray X-ray is one of the main diagnostic tools in medicine and is a form of electro-magnetic waves. They are shorter in wavelength than UV rays, longer in wavelength than gamma rays. fchs.ac.ae 1- Travel in straight lines. 2- Have a high penetrating power. 3- Photographic film is blackened by X-rays. 4- Not deflected by electric or magnetic fields. 5- Wavelength range of 0.01 to 10 nanometers. fchs.ac.ae fchs.ac.ae X-rays are produced when rapidly moving electrons that have been accelerated through a potential difference within an evacuated glass tube of order 1 kV to 1 MV strikes a metal target. fchs.ac.ae fchs.ac.ae X-Ray tube components 1- Glass envelope 2- Cathode 3- Anode 4- Protective housing fchs.ac.ae Anode parts 1- Router 2- Stator windings 3- Rotated disc fchs.ac.ae Cathode parts 1- Filament 2- Focusing cup fchs.ac.ae Steps of production of X-rays: 1- The source of electrons is the filament , heated by electric current 2- A high potential energy is applied, anode becomes strongly positive, cathode becomes strongly negative fchs.ac.ae 3- The electrons are forced to form a narrowing beam ( focusing cup) to the target. 4- Electrons are attracted towards the target and then the x-rays are produced when they hit the target. fchs.ac.ae The energy of the x-rays is dependent on the kinetic energy of the electrons. The kinetic energy of the electrons is converted into electromagnetic energy( x-ray) & heat in ratio of 1:99 correspondingly. (99% heat &1% x-ray) fchs.ac.ae SEE YOU NEXT CLASS Slide 42 fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Everyone must be held responsible to beat the coronavirus We must strictly adhere to safety protocols to curb the resurgence of virus Introduction to Radiography & Medical Imaging Radiographic terminology Introduction to Radiography & Medical Imaging Slide 1 fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Course Contents Standard terms Terminology of Positioning General planes Body landmarks Terminology of movement and direction fchs.ac.ae Stay Home-Stay Safe_ Commit to Win References Bontrager K.L: Textbook of Radiographic Positioning and Related Anatomy, Mosby; ISBN 0-323-01219-J. Whitely A.S: Clark's Positioning in Radiography, Hodder Arnold; ISBN 0-340-76390-6. fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Common Abbreviations Abbreviation Meaning MSP Medial Sagittal plane FFD Focal Film Distance PA Posteroanterior AP Anteroposterior Lat Lateral RAO Right Anterior Oblique LAO Left Anterior Oblique RPO Right Posterior Oblique fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Common Abbreviations LPO Left Posterior Oblique CR Central Ray ASIS Anterior Superior Iliac Spine D.O.B Date of Birth LMP Last menstrual Period MAS Millie Ampere Second KV Kilo Voltage fchs.ac.ae Stay Home-Stay Safe_ Commit to Win ANATOMIC & POSITIONING TERMINOLOGY fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Anatomic Terminology 1. Anatomic position: Erect, face forward, feet together, arms at sides with palms forward fchs.ac.ae Stay Home-Stay Safe_ Commit to Win 2. Plane Flat surface passed through the body or a portion of the body Longitudinal planes – Coronal – Sagittal Horizontal plane – Transverse (Axial) fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Body Planes 1 Coronal Plane. 2 Median Sagittal Plane. 3Axial Plane fchs.ac.ae Stay Home-Stay Safe_ Commit to Win cephalad Directional Terms Anterior cephalic superior cranial inferior caudal Lateral caudad Medial fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Lateral Posterior Anterior Proximal Distal fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Joint Movement Terms Extension: when the angle of the joint increases. Flexion: when the angle of the joint decreases. Abduction: refers to a movement away from the midline. Adduction: refers to a movement towards the midline. Rotation: movement of the body part around its own axis, e.g. medial (internal) rotation towards the midline, or lateral (external) rotation away from the midline. Pronation: movement of the hand and forearm in which the palm is moved from facing anteriorly (as per anatomical position)to posteriorly. Supination: is the reverse of this. fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Abduct Flexion Joint Movement Terms Adduct Extension fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Inversion ROTATION vs. CIRCUMDUCTION Eversion PRONATION vs. SUPINATION fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Body Position Terms Describe the overall placement of the body fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Erect Positions Surface of body closest to the film used to give a more specific description. Examples: Posterior erect – Patient is standing with the posterior surface of the body next to the cassette. fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Left lateral erect Patient is standing with the left side of the body next to the cassette Left lateral erect position fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Recumbent Positions Supine (posterior recumbent position) – Lying down on the back. Prone (anterior recumbent position) – Lying face down fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Right lateral recumbent - lying down on the right side like lying down Oblique (Erect or Recumbent) Position when the body is rotated so that the medial sagittal plane (MSP) is neither nor to the film but at an angle Exact position is indicated by the surface closest to the film and the angle of rotation May be erect or recumbent Abbreviations: ( RPO, LPO, RAO, LAO) 45 degres RPO fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Decubitus Positions Ventral decubitus: Patient is prone & a horizontal beam is used Dorsal decubitus : Patient is supine & a horizontal beam is used fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Left lateral decubitus : Patient lying on the left lateral side & a horizontal beam is used fchs.ac.ae Stay Home-Stay Safe_ Commit to Win PROJECTION Refers to the path the beam takes through part Anteroposterior projection (AP) Beam enters the front surface and exits the back surface of the part AP projection in supine position fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Posteroanterior projection (PA) Beam enters the back and exits the front of the part PA projection in prone position fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Special Projections (Position) Axial This projection includes, an angulation of the beam, usually to the long axis of the body part. AP axial with 40° Caudal angle fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Tangential Projection obtained when the central ray touches only along the edge of a curved body part fchs.ac.ae Stay Home-Stay Safe_ Commit to Win SEE YOU NEXT CLASS Slide 26 fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Everyone must be held responsible to beat the coronavirus We must strictly adhere to safety protocols to curb the resurgence of virus Introduction to Radiography & Medical Imaging The role of the radiographer Introduction to Radiography & Medical Imaging Slide 1 fchs.ac.ae Stay Home-Stay Safe_ Commit to Win A RADIOGRAPHER is a university-trained health professional who works with technology to produce X-rays, CT scans, MRI scans and other medical images to assist clinical radiologists. Course: FRD 4061 Medical imaging science and methods 6 (Image Interpretation)Lecture : Emergency Spine Slide 2 fchs.ac.ae Stay Home-Stay Safe_ Commit to Win COMMON TASKS The daily tasks of a radiographer require a precise work and adherence to strict safety procedures. Radiographer are required to be knowledgeable in all terminology related to radiography , anatomy and pathology. Radiographer deals with the special procedures frequently performed for diagnosis & for treatment. Should know about equipment, particularly the role of computers in imaging. The technologist must use good patient care, skills & be aware of medico-legal issues. Course: FRD 4061 Medical imaging science and methods 6 (Image Interpretation)Lecture : Emergency Spine Slide 3 fchs.ac.ae Stay Home-Stay Safe_ Commit to Win The responsibility which radiographer carry for patient in their department may be consider in their procedure: A) Clinical responsibility B) Ethical responsibility C) Legal responsibility Course: FRD 4061 Medical imaging science and methods 6 (Image Interpretation)Lecture : Emergency Spine Slide 4 fchs.ac.ae Stay Home-Stay Safe_ Commit to Win A) CLINICAL RESPONSIBILITY To carry out day work radiographer need some knowledge of practical procedure in the care of the patient , some knowledge of pathology and diseases process so that they do not worsen a diseases by uniformed handling of the patient Some knowledge of first aid and what to do in emergency situation so that they will be able to help the patient until the medical assistant arrive. Course: FRD 4061 Medical imaging science and methods 6 (Image Interpretation)Lecture : Emergency Spine Slide 5 fchs.ac.ae Stay Home-Stay Safe_ Commit to Win B) ETHICAL RESPONSIBILITY: It may be defined as the science of human duty and also important factor in radiographer and patient relationship there are two special element in this responsibility Discretion in speech and absolute necessity not to reveal information about the patient which is confidential. It is radiographer duty to give minimum radiation dose to the patient. Responds to patient needs and supports co-partner and associates in providing quality patient care. Course: FRD 4061 Medical imaging science and methods 6 (Image Interpretation)Lecture : Emergency Spine Slide 6 fchs.ac.ae Stay Home-Stay Safe_ Commit to Win C) LEGAL RESPONSIBILITY Break of professional confiditional. The radiographers should regard as confidential any information about the patient, available from the case sheets during the routine work. To disclose any such information , the results of investigation done in the department or any other confidential or personal information gained about the patient during departmental work , constitute professional misconduct. Course: FRD 4061 Medical imaging science and methods 6 (Image Interpretation)Lecture : Emergency Spine Slide 7 fchs.ac.ae Stay Home-Stay Safe_ Commit to Win RADITION PROTECTION Protect the patient from unnecessary radiation specially thyroid ,gonad and eye protected from radiation by proper shielding. Collimate the proper examination area. Keep radiation dose as low as possible. Use filter to remove low energy radiation. Course: FRD 4061 Medical imaging science and methods 6 (Image Interpretation)Lecture : Emergency Spine Slide 8 fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Diagnostic radiographers Plain Film CT MRI Ultrasound Nuclear Medicine Contrast Imaging Interventional Ward & Theatre Bone Scanning Cardiac fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Therapeutic radiographers take lead responsibility for the management and care of patients with cancer undergoing radiotherapy during the pre-treatment, treatment delivery and immediate post-treatment phases. fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Therapeutic Radiographers Planning Review Treatment Counselling Community Liaison End Of Treatment Palliative Satellite RT Info & Support Brachytherapy fchs.ac.ae Stay Home-Stay Safe_ Commit to Win In the Radiology Theatres the Radiographer is an essential part of the team. A large X-Ray camera (C-arm) is used in all the procedures, which allows the Doctor (Radiologist) to see the area of the body they are diagnosing or treating in real time. The Radiographer ensures that the radiation used is safely monitored and moves the equipment while the Radiologist is scrubbed in sterile gloves and gown. The Radiographer will also ensure that important information is recorded after the operation, including all the images they have saved throughout. Course: FRD 4061 Medical imaging science and methods 6 (Image Interpretation)Lecture : Emergency Spine Slide 12 fchs.ac.ae Stay Home-Stay Safe_ Commit to Win The Radiographer will know where all the equipment the Radiologist might need is and how to open them so they stay clean. Often the Radiographer is the only member of the team that is not scrubbed in sterile gloves and gowns so monitoring the patient, getting equipment and documenting important information also becomes part of their responsibility. Course: FRD 4061 Medical imaging science and methods 6 (Image Interpretation)Lecture : Emergency Spine Slide 13 fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Considering Diagnostic Radiography as a career? It is a 3 year undergraduate course which involves a large amount of placement in a clinical environment. This involves learning how to do plain film X-Rays, such as in A&E. It also includes periods of time in CT, MRI, Nuclear Medicine, Ultrasound and Radiology Theatres. Course: FRD 4061 Medical imaging science and methods 6 (Image Interpretation)Lecture : Emergency Spine Slide 14 fchs.ac.ae Stay Home-Stay Safe_ Commit to Win With rapid technological and innovative advances in radiology, plus transformation of the field, this assisting role has developed increasing importance and is now an essential part of the smooth operation of radiology, nuclear medicine, radiotherapy and medical physics. Responsibilities in radiology are manifold, needing a multitalented approach. Course: FRD 4061 Medical imaging science and methods 6 (Image Interpretation)Lecture : Emergency Spine Slide 15 fchs.ac.ae Stay Home-Stay Safe_ Commit to Win An radiographer's tasks fall into three main areas: logistics, management and examination. They manage patients from admission to discharge, acting as a constant contact for reassurance and information during radiology department visits, as well as transporting patients between wards and departments. Radiographer also help to maintain image processing systems and accessory equipment and report on faulty equipment. Course: FRD 4061 Medical imaging science and methods 6 (Image Interpretation)Lecture : Emergency Spine Slide 16 fchs.ac.ae Stay Home-Stay Safe_ Commit to Win An radiographer also needs concentration and precision to help perform the rising numbers of complex examinations and interventional procedures. Incorrect or incorrectly processed images lead to wrong diagnoses, or more work if the formatting must be redone – losing time and costing more. In other words, the quality of a radiographer’s work can underpin fast, precise diagnosis. Last but not least, good teamwork is a vital prerequisite for any successful radiographer, by relating well with radiology department colleagues, physicians, nurses, auxiliaries, porters and all others involved in patients’ welfare. Course: FRD 4061 Medical imaging science and methods 6 (Image Interpretation)Lecture : Emergency Spine Slide 17 fchs.ac.ae Para Medical Staff (e.g Radiographers) Director Consultant Radiologist In Charge Consultant Radiologists Registrar Radiology Trainees Principal School of Radiography Tutors Students Superintendent Radiographer (Special grade) Section heads Senior radiographers Junior Radiographers fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Divisions in Radiology/Medical Diagnostic Imaging General Radiography – Plane radiography – Tomography Fluoroscopy – Conventional – Digital Contrast Radiography CT scanning MRI Nuclear Imaging/Medicine Ultrasound Scanning Computerized Radiography Digital Radiography Interventional Radiology fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Radiotherapy Techniques & Instrumentation Brachytherapy – Radioisotopes – Radiopharmaceuticals Chemotherapy - Non Radiation Technique Teletherapy – Cobolt Therapy – Megavoltage X-ray therapy – Linear Accelerators – CT Simulation – Moulding /Masking – PETCT fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Responsibilities of Radiographers/RTs To be an effective member of the Team of Health-care Professionals who work in consort to maximize patient wellness Responsibilities towards the Department/Institution Responsibilities towards the patient fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Responsibility As a member of the Health care team The Radiographer is governed by a Code of Ethics and Principles of Professional Conduct (Note :- To be discuss in detail later) fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Responsibilities towards the Department/Institution As a government servant, to work according to the rules and guidelines as given in the Establishment Code and the Financial Regulations. If in a private hospital to follow their rules and regulations To carryout the duties as laid down in the ‘Duty List’ of Radiographers fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Responsibilities towards the patient To protect the patient’s rights To provide appropriate patient care when he/she is in the imaging/treatment department or undergoing a diagnostic/therapeutic procedure. To provide adequate patient protection from unnecessary radiation or any other sort of hazard when he/she is in RT’s care. fchs.ac.ae Stay Home-Stay Safe_ Commit to Win SEE YOU NEXT CLASS Slide 25 fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Everyone must be held responsible to beat the coronavirus We must strictly adhere to safety protocols to curb the resurgence of virus Introduction to Radiography & Medical Imaging Radiology department in clinical settings Introduction to Radiography & Medical Imaging Slide 1 fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Diagnostic imaging Modalities Plain x-rays Which of these modalities use ionizing radiation? Fluoroscopy Mammography Nuclear Medicine,conventional,Spect/Pet Ultrasound CT Scan MRI Angiography fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Three things can happen X-rays can: – Pass all the way through the body – Be deflected or scattered – Be absorbed Where on this image have x-rays passed through the body to the greatest degree? fchs.ac.ae Stay Home-Stay Safe_ Commit to Win 5 Basic Radiographic Densities 1. Air Fat Soft tissue/fluid Mineral Metal 2. 4. 5. 3. Name these radiographic densities. fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Plain x-ray's Indications X-ray chest. Chest trauma,Infection,Tumour X-ray abdomen. Acute abdomen,eg Renal Colic,Obstruction,tumour and infection Bone x-ray.Bone fracture,Infection and tumours. fchs.ac.ae Stay Home-Stay Safe_ Commit to Win AP and PA chest positions fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Chest PA view Chest AP view fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Ultrasound fchs.ac.ae Stay Home-Stay Safe_ Commit to Win US Indications: OB/GYN.Evaluation of Ist,secnd and third trimester pregnancy Congenital Anamolies. Evaluation of placenta previa and haemorrhages Evaluation of gyenacological diseases. Abdominal indications. Muscuskeletal indicaions Neonatal brain ultrasound. fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Ultrasound Advantages 1. No ionizing radiation 2. Applicable to any plane 3. Cost-effective 4. Portable 5. Real-time imaging Disadvantages 1.Operator dependent 2. Can not penetrate every structure like bone and air containing organs fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Ultrasound fchs.ac.ae Stay Home-Stay Safe_ Commit to Win 3-4 D U/S images fchs.ac.ae Stay Home-Stay Safe_ Commit to Win CT Scan fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Computed Tomography fchs.ac.ae Stay Home-Stay Safe_ Commit to Win CT angiography Angiography images Rapid intravenous injection of contrast media result in significant opacification of blood vessels, which with multiplanner or 3D reconstruction, can be can be exploited to produce an angiogram. CT angiography along with MRA is gradually replacing conventional angiography fchs.ac.ae Stay Home-Stay Safe_ Commit to Win MRI fchs.ac.ae Stay Home-Stay Safe_ Commit to Win MRI Advantages of MRI Disadvantages Best for soft tissue imaging There is no ionizing radiation Procedure of choice for MSK It can be done for pregnant women with caution. Multiplanner so image can be taken in any plan with out changing the position of the patient. MR angiogram can be perform wit out introducing contrast media Expensive and time consuming Patient fear it and dislike it because it is a narrow place(claustrophobia). Now a days open MRI system has over come this problem Since it is magnetic no metal can be allowed Patient has to keep still during the producer. fchs.ac.ae Stay Home-Stay Safe_ Commit to Win MRI continue Axial sagittal fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Contraindications Of MRI If There Is Cardiac pace maker Intracranial vascular clips Neurostimulators of any kind Intraocular metallic foreign body Ossicular implants Any metallic implants, rods, metal plates and pins. Heart failure Surgical clips on arteries and wire sutures fchs.ac.ae Stay Home-Stay Safe_ Commit to Win MR Angiography MRA Unlike CT angiography, MRA can done with out contrast. But in contrast enhanced MRA, contrast is often used to make blood vessel show up more clearly. fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Fluoroscopy Utilizes X-Rays Real-time imaging Utilizes image intensifier May involves use of contrast agents fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Fluoroscopy X-ray beams from Mechanism: Continuous below patient, amplified by intensifier above patient; shown on high-resolution television screen  Provides real time moving image of internal structure.  Imaging reversed vs x-ray  Uses: Barium swallow to evaluate esophagus, small and large intestines, vessel catheter guidance fchs.ac.ae Stay Home-Stay Safe_ Commit to Win fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Advantages Disadvantages Widely Available Inexpensive Functional and Anatomic No sedation required High radiation dose ingestion/injection of contrast Patient cooperation Time consuming fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Gastrointestional Fluoroscopy Esophogram /Barium Swallow Modified Barium Swallow Small Bowel Series Enteroclysis Contrast Enema fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Barium swallow spot films fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Hysterosalpingogram Used to evaluate endometrial canal and fallopian tubes Infertility and uterine anomalies Dye injected into cervical os under fluoro Injection continued with goal to opacify the fallopian tubes and spill contrast into peritoneum fchs.ac.ae Stay Home-Stay Safe_ Commit to Win fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Nuclear Medicine (Scintigraphy) Bone Scan fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Radionuclide study Indications: Detection of bone infections, tumor and fractures. Thyroid diseases Cardiac Imaging e.g. perfusion images. Brain images. Tumor and infections. fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Single-photon emission computed tomography (SPECT) is a nuclear medicine tomographic imaging technique using gamma rays. It is very similar to conventional nuclear medicine planar imaging using a gamma camera However, it is able to provide true 3D information which is then presented as cross sectional image. fchs.ac.ae Stay Home-Stay Safe_ Commit to Win SPECT Scanner fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Mammography Mammography is the process of using low-energy X-rays (usually around 30 kVp) to examine the human breast and is used as a diagnostic and a screening tool. The goal of mammography is the early detection of breast cancer, typically through detection of characteristic masses and/or microcalcifications. fchs.ac.ae Stay Home-Stay Safe_ Commit to Win Diagnostic Mammogram For woman presenting with clinical evidence of breast disease, palpable mass or other symptom Uses specific projections to – Rule out cancer – Demonstrate suspicious area seen on screening mammogram fchs.ac.ae Stay Home-Stay Safe_ Commit to Win CC view ( lesion) fchs.ac.ae Stay Home-Stay Safe_ Commit to Win SEE YOU NEXT CLASS Slide 36 fchs.ac.ae