Essential physics for FRCR - Day 1

Essential physics for FRCR Meeting organised by the North Branch of The British Institute of Radiology Thursday 29 January 2015 Hilton Hotel, Sheffield 08:30

Registration and refreshments

09:00

Basic physics review Dr John Fenner, Medical Physicist, The University of Sheffield

09:30

IR(ME)R Ms Karen Fuller, Lead Physicist, Sheffield Teaching Hospitals NHS Foundation Trust

10:30

Refreshments

10:40

Workshops

11:40

The physics of digitial radiology Dr John Kotre, Head of Diagnostic Radiology Physics and Radiation Protection Group, The Christie NHS Foundation Trust

12:10

The physics of computed tomography Dr Lorna Sweetman, Clinical Scientist and Radiation Protection Adviser, The Christie NHS Foundation Trust

12:40

Lunch

13:30

Ultrasound Mr Stephen Russell, Principal Clinical Scientist The Christie NHS Foundation Trust

Incorporated by Royal Charter Patron - Her Majesty The Queen

President Dr David Wilson MBBS BSc MFSEM FRCP FRCR Chief Executive Ms Jacqueline Fowler BA, MInstF(Cert)

The British Institute of Radiology 48-50 St John Street London EC2M 4DG

T : +44(0)20 3764 5710 E : admin@bir.org.uk www.bir.org.uk

Registered Charity No. 215869 VAT Registration No. GB 233 7553 63

14:00

Nuclear medicine Dr Tony Hughes, Radiation Protection Adviser Royal Preston Hospital

14:30

Refreshments

14:40

Workshops

15:40

MR contrast agents and acquisition techniques Professor Andrew Jones, Consultant Clinical Scientist, The Christie NHS Foundation Trust

16:10

Summary of workshops, discussions and Q&A

17:00

Close of day This meeting has been awarded 7 RCR category I CPD credits.

Your certificate of attendance will be emailed to you within the next two weeks once you have completed the online survey at: https://www.surveymonkey.com/s/Essentialphysics2015

We are most grateful to

For supporting this event

Speaker profiles Dr John Fenner, Medical Physicist, The University of Sheffield Dr John Fenner is a medical physicist and registered clinical scientist (CS00737). His career began in 1984 as a trainee with thedepartment Clinical Physics and Bioengineering in Glasgow. 1996 saw a move to the medical physics department in Sheffield with responsibilities for teaching and research. Currently, this includes appointment as course coordinator for undergraduate medical physics teaching in Sheffield as well as numerous postgraduate responsibilities.

With respect to research, he has strong links with the Virtual Physiological Human (http://vph-portal.eu/) and the Insigneo Institute for in silico medicine at the University of Sheffield (insigneo.org). His interests have led to publications in medical radiation physics and aspects of diagnostic imaging, and he is an associate editor of the Journal of Medical Engineering and Technology.

Ms Karen Fuller, Lead Physicist, Sheffield Teaching Hospitals NHS Foundation Trust Karen Fuller is one of the lead physicists in radiology physics at Sheffield Teaching Hospital NHS Foundation Trust. She graduated from Newcastle University with a BSc (Hons) in physics with medical applications, and an MSc in instrumentation and analytical science (with biomedical and bioanalytical measurement) from UMIST. After graduation Karen began working as a trainee radiation protection adviser (RPA) with the NRPB (now part of Public Health England) before joining Sheffield Teaching Hospitals in 2003. Karen has held a certificate to act as an RPA since 2007 and is a MPE for diagnostic radiology. As a member of BIR, SRP and IPEM, she served on IPEM’s radiation protection special interest group for a number of years.

Serving as secretary of the group for a couple of years, she twice organised and chaired the annual RPA update; working closely with the regulators and Department of Health. Karen has been involved in teaching the physics and regulatory aspects of the FRCR course for over 10 years.

Dr Tony Hughes, Radiation Protection Adviser, Royal Preston Hospital Tony Hughes is a state registered medical physicist with more than 20 year’s clinical experience in clinical nuclear medicine, with a further 7 year’s experience as a certified radiation protection adviser.

Since 2004 he has been the lead tutor for FRCR Part 1 physics at the University of Liverpool, and for the past 8 years has been an examiner for the Institute of Physics and Engineering in Medicine (IPEM) part 1 training scheme. He currently sits on the Royal College of Radiologists first FRCR Examination Committee (Physics).

Professor Andrew Jones, Consultant Clinical Scientist, The Christie NHS Foundation Trust Andrew Jones is a Consultant Clinical Scientist based at The Christie NHS Foundation Trust in Manchester. He is group leader for non-ionising imaging within Christie Medical Physics and Engineering. His team at The Christie provide scientific support to projects at The Christie, including MR biomarker imaging in cancer and the development of an MR LINAC and MR simulator techniques for personalised cancer treatment. The team also provides scientific support to hospitals and units across the north west of England along with support to national imaging providers.

Andrew is heavily involved in the teaching of MR physics and MR clinical applications at numerous institutions and organisations and he is passionate about good effective teaching for radiographers, clinicians and scientists. He has been involved in many roles with the Institute of Physics and Engineering in Medicine, the Royal College of Radiologists and The British Institute of Radiology. He is the immediate past president of The British Institute of Radiology.

Dr John Kotre, Head of Diagnostic Radiology Physics and Radiation Protection Group, The Christie NHS Foundation Trust John Kotre is head of the diagnostic radiology physics and radiation protection group at The Christie, Manchester. He has taught aspects of FRCR physics since 1983, recently at Manchester and previously for many years at Newcastle. He also served on the RCR physics working group (2005-2010), helping to set the FRCR physics multi-choice papers, so he is in a good position to discuss some of the physics material in the context of how it might be examined in the multi-choice format.

Mr Stephen Russell, Principal Clinical Scientist, The Christie NHS Foundation Trust Stephen Russell is a principal clinical scientist within Christie medical physics and engineering at The Christie, Manchester and is section leader for the ultrasound section of the non-ionising imaging group. The groups’ ultrasound section provides both scientific support and maintenance services to ultrasound users across the North West. He supports a number of courses at several institutions covering the physics of ultrasound and was editor of the latest IPEM report (102) on the quality assurance of ultrasound systems.

Dr Lorna Sweetman, Clinical Scientist and Radiation Protection Adviser The Christie NHS Foundation Trust Lorna Sweetman is a Clinical Scientist and Radiation Protection Adviser based in the Diagnostic Radiology and Radiation Protection Group of Christie Medical Physics and Engineering. She has been involved in physics teaching for the North West Deanery School of Radiology (Manchester Radiology Training Scheme) since 2009.

Abstracts (where supplied) Basic physics review Dr John Fenner This revision lecture will cover a selection of basic physics topics as outlined in the FRCR syllabus. Time constraints necessarily require the delivery of condensed content, but emphasis will be given to concepts central to the curriculum. This will begin with properties of matter, acknowledging atomic structure (electrons, protons, neutrons) and the relevance of electric charges.

The study of the latter is the basis of electrostatics, recognising that disturbance of the electric field equilibrium leads to electrodynamics and production of the photon.

This is the background to a description of electromagnetic/ionising radiation, focussing on X-ray production and interaction with matter. Processes relating to absorption, scatter and attenuation of X-rays will be discussed, with specific reference to the photoelectric, Compton and pair production effects. This naturally leads to consideration of absorbed dose, the inverse square law and exponential behaviour.

IR(ME)R Ms Karen Fuller This session is a reminder of the key aspects of the ionising radiation (medical exposure) Regulations 2000 (and subsequent amendments in 2006 and 2011).

IR(ME)R partially implements the Council Directive 97/43/Euratom within Great Britain, which concerns the health protection of individuals against the dangers of ionising radiation in relation to medical exposure. The requirements, terminology and applications of the legislation will be reviewed.

The physics of digital radiology Dr John Kotre This presentation will cover the formation and digitisation of the image, digital subtraction angiography, computed radiography and the most common direct digital radiography designs, with emphasis on the performance characteristics, advantages and disadvantages of the technology. Discussion of x-ray image intensifiers, digital subtraction angiography, PACS and image display and processing will also be included. Common terms and variables used in the construction of FRCR questions will be defined, and the relationships between them will be highlighted.

Learning outcomes: Review of digital radiology technology. Comparison of technologies and relative performance. Identification of common terms used to describe performance and the relationships between them.

The physics of computed tomography Dr Lorna Sweetman This talk will consider the principles of computed tomography. We will look at the advantages and disadvantages of CT relative to other techniques and discuss hardware technology and image reconstruction methods. The factors governing the appearance of the CT image and those that affect image quality, including common artefact types, will be reviewed. Delegates will be reminded of practical approaches to staff protection in CT and how the typical patient doses compare to other imaging modalities. The requirements of the newer CT applications, for example gated imaging and perfusion, will be summarised.

The talk aims to help delegates to synthesise the information they have already studied, highlighting the relationships between different elements and the interactions that lead to compromises between competing aspects of image quality.

At the end of the talk delegates should have consolidated their previous knowledge of CT and: • be able to describe the function and operation of the main components in a CT scanner • understand the influence of scanning parameters and reconstruction algorithms on image quality and patient dose • appreciate the quantitative nature of CT images • be familiar with the main causes of image artefacts and their appearance • appreciate the magnitude of radiation dose and the risks associated with CT scanning Ultrasound Mr Stephen Russell Diagnostic ultrasound is based on a pulse imaging technique where short duration pulses of high frequency sound are transmitted into tissue and the subsequent echoes used to generate an image. On modern systems this is now layered with additional complexities, in fact on some systems the process itself may be changing.

Key facts on the operations of such systems, which physical limitations remain and which have been overcome, are important in understanding the operation of modern ultrasound systems.

Changes in the way a system transmits sound to produce images invariably impacts on the safety of ultrasound with both the thermal and cavitation risk potentially changing. The purpose of the presentation is to review the fundamental operation of the ultrasound imaging system and consider the impact of the pulse/echo requirements in respect to ultrasound safety.

Nuclear medicine Dr Tony Hughes This talk will review the basic science of nuclear medicine imaging including the following topics: • The design and operation of the gamma camera o The collimator o NaI crystal o PM tubes and pulse processing • Factors affecting patient dose & image quality o Injected activity o Effective half-life o Spatial resolution, contrast and noise • Radiation protection considerations for patients o Conception o Pregnancy o Breastfeeding • Additional legislative requirements for nuclear medicine o EPR 2010 o MARS 1978 • Physics of SPECT imaging o Detector requirements o Factors affecting image quality • Physics of PET imaging o Coincidence detection o Block detectors and scanner design o FDG scanning o 2D and 3D acquisitions o Factors affecting image quality MR Professor Andrew Jones This talk will provide • • • • • • • •

An appreciation of the key areas of MR physics which are considered important for radiologists in clinical practice A basic familiarity with the origins of the MR signal and image encoding mechanisms An understanding of the implications of the fundamental physics that underpins image acquisition in terms of sequence types and artifacts A general understanding of contrast mechanisms within generic types of MR sequences and the influence of scan parameters on image contrast and appearance A basic understanding of the factors that influence spatial resolution and signal to noise within image acquisition An understanding of the factors that can produce artifacts within MR images and strategies to minimise or remove them A knowledge of the key safety aspects associated with clinical MR imaging An awareness of the fundamental guidance available for MR and the nature

•

of the safety framework required by this guidance An understanding of the main risks and hazards for patients and for staff arising from MR

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