Contrast study day 2015

Contrast study day Event organised by the North Branch of The British Institute of Radiology Friday 30 January 2015 Hilton Hotel, Sheffield 09:00

Registration and refreshments

09:20

Welcome

09:30

General applications for CT Dr Matthew Bull, Consultant Radiologist, Sheffield Teaching Hospitals NHS Foundation Trust

10:00

General applications for MR Dr Peter Wright, Principal MRI Physicist, Sheffield Teaching Hospitals NHS Foundation Trust

10:30

Dynamics of blood flow within the body Dr Sapna Puppala, Consultant Cardiovascular Radiologist and Endovascular Specialist, Leeds Teaching Hospitals NHS Foundation Trust

11:00

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

11:30

Refreshments

11:50

CT Angiography Dr Doug Turner,Consultant Vascular Radiologist, Sheffield Teaching Hospitals NHS Foundation Trust

12:20

Safety aspects of contrast agents Dr Matthew Bull, Consultant Radiologist, Sheffield Teaching Hospitals NHS Foundation Trust, Proffessor Andrew Jones, Consultant 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

12:50

MR angiography Dr Doug Turner, Consultant Vascular Radiologist, Sheffield Teaching Hospitals NHS Foundation Trust

13:20

Lunch

14:10

Contrast media in children Dr Ashok Raghavan, Consultant Paediatric Radiologist, Sheffield Children’s Hospital

14:40

CT abdomen and CT colongraphy Dr Rachel Hyland, Consultant Radiologist, Leeds Teaching Hospitals NHS Foundation Trust

15:10

Small bowel imaging and contrast agents Dr Hannah Lambie, Consultant Radiologist, Leeds Teaching Hospitals NHS Foundation Trust

15:40

Refreshments

16:00

CT and MR of the liver Dr Tony Blakeborough, Sheffield Teaching Hospitasl NHS Foundation Trust

16:30

Q&A session and discussion

17:00

Close of meeting This meeting has been awarded 6 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/Constraststudy2015 We are most grateful to

For supporting this event

Speaker profiles Dr Matthew Bull, Consultant Radiologist Sheffield Teaching Hospital NHS Foundation Trust Matthew Bull is a Consultant Radiologist with interest in chest and endocrine imaging at Sheffield Teaching Hospitals NHS Foundation Trust and honorary senior lecturer at Sheffield University.

He undertook his radiological training in Sheffield with a fellowship at State University of New York before becoming a consultant in Sunderland. Since 1991 he has been a consultant in Sheffield and more recently Clinical Director.

He has been senior examiner for the FRCR 2b, examiner for FRCR 2A question setting and also examined in Hong Kong, Sri Lanka and Ireland. He has been involved in teaching all his career.

Matthew lives in rural Derbyshire with a large family. He suffers from being a Sheffield United supporter.

Dr Peter Wright, Principal MRI Physicist, Sheffield Teaching Hospital NHS Foundation Trust After being awarded a PhD in MRI physics at the University of Nottingham, Peter started training towards becoming a clinical scientist at the University Hospital North Midlands (UHNM). Peter continued his training at Leeds Teaching Hospital, where he was resident MRI physicist to the NIHR Leeds musculoskeletal and biomedical research unit (LMBRU) for 3 years. Since then, Peter returned to UHNM to establish and develop an MR physics team and is now principal MRI Physicist at Sheffield Teaching Hospitals NHS Foundation Trust.

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 Doug Turner, Consultant Vascular Radiologist, Sheffield Teaching Hospitals NHS Foundation Trust

Doug Turner has been a Consultant Vascular Radiologist in Sheffield since 2005.

Prior to taking up a consultant post, he undertook a fellowship in Sheffield after general radiology training in Cambridge.

His job comprises all aspects of vascular disease diagnosis and intervention, outside the coronary and intracranial circulations.

Dr Rachel Hyland, Consultant Radiologist Leeds Teaching Hospitals NHS Foundation Trust Rachel Hyland is a consultant radiologist in Leeds, with a sub-specialty interest in GI and sarcoma imaging.

Dr Hannah Lambie, Consultant Radiologist Leeds Teaching Hospitals NHS Foundation Trust Hannah Lambie trained as a radiologist in Leeds/West Yorkshire and is a consultant radiologist specialising in gastro-intestinal radiology at St James’s University Hospital, Leeds.

Abstracts (where supplied) General applications for MR Dr Peter Wright Revision of: • longitudinal (T1)and transverse (T2 / T2*) relaxation mechanisms • Pulse sequences – gradient echo, spin echo, fast spin echo (TSE/FSE) • Fat saturation techniques, specifically spectral fat saturation By the end of the lecture delegates should be familiar with relaxation techniques, T1, T2 and T2* and the basic spin echo (SE), gradient echo (GE) and fast spin echo (FSE/TSE) sequences. This will be followed by revision of spectral fat saturation and STIR, including why STIR would not be used when administering contrast.

MR contrast agents and acquisition techniques Professor Andrew Jones Learning objectives: • • • • • • •

An understanding of the nature and action of different MR contrast agents An awareness of the differing agents available in the market along with their applications and special characteristics An overview of the nature of MR data capture and implications for the resulting image appearances A basic understanding of spatial frequency properties of k-space and the different filling regimens An appreciation of the use of different methods of k-space filling and their advantages for MR angiography techniques A general understanding of the basic physics that underpins contrast enhanced MR angiography An understanding of bolus timing and data acquisition strategies used in MR angiography

CT angiography Dr Doug Turner Computed tomography angiography (CTA) is an important tool in the diagnosis of vascular disease. Technological developments in scanner design in the last 20 year’s, along with huge advances in computational power, have allowed greatly improved spatial and temporal resolution imaging to be manipulated in powerful post-processing algorithms; acquired isotropic volumetric data can be reformatted in a plane, and luminal centre-line techniques for example, allow accurate stenosis assessment and endovascular device sizing.

Educational objectives • To understand the technological advances which have enabled vascular diagnosis to become non-invasive • Illustrate the variables which can affect quality of CTA

•

Highlight current role of CTA in diagnosis of vascular conditions, including o Acquisition technique o Interpretation/pitfalls

Safety aspects of contrast agents Dr Matthew Bull and Professor Andrew Jones This talk will give you: • • • • • •

An appreciation of the general safety profile of gadolinium based MR contrast agents An awareness of differences between various types of MR contrast agents in terms of their basic chemistry and excretion paths in-vivo An understanding of the risks posed by nephrogenic systemic fibrosis (NSF) and the relationship with gadolinium contrast agents An understanding of the differing nature of various MR contrast products and the associated risk factors for NSF A knowledge of the licence implications around NSF for high risk agents An awareness of the most up to date guidance on the safe use of gadolinium contrast agents and their implications for clinical practice

MR Angiography Dr Doug Turner Magnetic resonance angiography has become an integral part of the assessment of vascular disease, offering a number of advantages over conventional catheter angiography and other techniques. There are various different ways to obtain angiographic imaging, but the mainstay is contrast enhanced imaging.

Educational Objectives • To recognise there are different ways to obtain angiographic style imaging • Understand how contrast enhanced MRA imaging is obtained.

• Review some of the uses of MRA, limitations and pitfalls.

CT abdomen and CT colongraphy Dr Rachel Hyland Educational objectives: • CT examinations of the abdomen have to be tailored to the particular clinical request • Contrast options include oral contrast (negative and positive) and intravenous (non-contrast, arterial, portal venous or delayed).

• Protocols for individual types of examination will be covered, explaining their rationale • CT colonography (CTC) is a technique allowing additional evaluation of the colon for the detection of polyps and cancers.

• Bowel preparation is important, and various options will be discussed • CTC technique will be covered, bowel insufflation, faecal tagging and scan position • Examples of pathology at CTC will be shown

Small bowel imaging and contrast agents Dr Hannah Lambie Educational Aims: To explore the different methods to assess the small bowel, when to use them and the contrast media used in imaging the small bowel Talk outline: The different methods to assess the small bowel including endoscopic and radiological methods will be discussed. The pros and cons of each method and their relative uses will be reviewed. Particular reference will be made to the contrast media used to image the small bowel.

Learning outcomes: • Describe the methods used to assess the small bowel • Understand the indications for imaging the small bowel and when to use the different imaging techniques • Know which contrast media are used and the rationale for using then

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