Essential physics for FRCR Meeting organised by the North Branch of The British Institute of Radiology Thursday 23 January 2014 Liverpool Medical Institute
08:00
Registration, tea and coffee
Chair:
Dr Klaus Irion, Consultant Chest Radiologist, Liverpool Heart and Chest Hospital
08:30
Quiz
09:00
Basic physics review Dr Philip Mayles, Head of Physics, The Clatterbridge Cancer Centre NHS Foundation Trust
09:30
The physics of digital radiology Dr John Kotre, Head of the Diagnostic Radiology Physics and Radiation Protection Group, The Christie NHS Foundation Trust
Incorporated by Royal Charter Patron - Her Majesty The Queen
President Prof Andrew Jones BSc MSc FIPEM CSci FBIR 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 3668 2226 E : admin@bir.org.uk www.bir.org.uk
Registered Charity No. 215869 VAT Registration No. GB 233 7553 63
10:00
Fluoroscopy Dr Mike Moores, Director, Integrated Radiological Services Ltd
10:30
Coffee and into workshops
10:40
Workshops
11:40
IR(ME)R essentials Mr Peter Hiles, Head of Radiation Physics, North Wales
12:10
Computed tomography Dr Lorna Sweetman, Clinical Scientist, The Christie NHS Foundation Trust
12:40
Lunch and quiz
13:30
Ultrasound Mr Stephen Russell, Principal Physicist, The Christie NHS Foundation Trust
14:00
Nuclear medicine Dr Anthony Hughes, Medical Physicist, Royal Preston
Hospital 14:30
Tea and coffee
14:40
Workshops
15:40
MR physics Professor Andrew Jones, Consultant Clinical Scientist, The Christie NHS Foundation Trust
16:10
Answers to MCQ’s, problems and panel discussions
17:00
Close of meeting
CPD: 7 credits Please complete the meeting evaluation survey online at: https://www.surveymonkey.com/s/physics_day1 We will email your CPD certificate upon collation of your feedback.
We are most grateful to
For supporting this conference
Bayer HealthCare has provided sponsorship for the cost of the exhibition stand only at this meeting.
Speaker profiles and abstracts (where supplied) Biography Professor Philip Mayles, Head of Physics, The Clatterbridge Cancer Centre NHS Foundation Trust
Philip Mayles has been Head of Physics at Clatterbridge Cancer Centre since 1994. During this time he has led the development of a number of advanced radiotherapy techniques. Together with Alan Nahum and Jean-Claude Rosenwald he edited the Handbook of Radiotherapy Physics. He teaches on the University of Liverpool MSc in Clinical Science (Medical Physics) and has responsibility for the training of Medical Physicists in Radiotherapy in Liverpool. Abstract
Basic physics review This talk will cover the basic physics of diagnostic radiology with ionising radiation. Included will be: photoelectric and Compton interactions and image quality (contrast, noise and spatial resolution). Dose considerations in planar and CT imaging will also be considered. A brief introduction to the physics of PET imaging will also be given.
Biography Dr John Kotre, Head of the 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. Abstract The physics of digital radiology This presentation will cover the 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. A brief discussion of PACS and image display and processing will also be included.
Abstract
Dr Mike Moores, Director, Integrated Radiological Services Ltd Fluoroscopy The definition of a fluoroscope is a device equipped with a fluorescent screen on which the internal structures of an opaque object, such as the human body, may be continuously viewed as images formed by the differential transmission of x-rays through the object. The mechanism for image formation is common to radiography and fluoroscopy but the latter provides dynamic/continuous reproduction. In the early days radiologists would view a fluorescent screen directly during an x-ray exposure. Because the images were of low intensity they were required to dark adapt their eyes in order to employ scotopic vision, which was applicable to low luminance images. Scotopic vision depends upon the rods within the retina as distinct from the cones. Since rod vision provides relatively poor resolution but high sensitivity visual acuity is not employed optimally by a human observer. Following war time developments in the field of image intensification aimed at improving night vision, image intensification was applied to fluoroscopic images in order to increase image brightness so that rod dependent vision could be employed, thus providing increased visual acuity for the radiologist. However, image and associated contrast perceptibility is still dictated by statistical fluctuations within the image, which are dictated by quantum and system noise processes. This is due to the fact that dose rates (exposure per second) must be limited so that the overall (integrated) dose to a patient during an examination, which might take from seconds to minutes for completion, is acceptable. Such limitations also dictate the most beneficial clinical applications for this imaging modality, which often involves the use of contrast agents. The basic elements of modern fluoroscopic systems will be described including the basis of intensification and the relevance of patient and detector dose to image quality. The talk will also highlight how new x-ray detector technology has now blurred the boundaries between fluoroscopy and other x-ray imaging modalities including both radiography and CT where time domain, multi frame imaging studies are feasible. Educational aims:
Reinforce the role of quantum statistics in determining X-ray image quality Understanding the reasons for and nature of technological developments in fluoroscopy The role and relevance of patient dose to risk-benefit outcomes from X-ray examinations Learning outcome:
An improved understanding of the physical and technological basis of Xray image formation.
Biography Mr Peter Hiles, Head of Radiation Physics, North Wales Head of Radiation Physics in North Wales and the current chair of the BIR’s Radiation Protection Special Interest Group. He has over 30 years experience in Medical Physics and has acted as an adviser to the IAEA and EU on radiation protection and quality assurance. He was the chair of the working party which produced the popular IPEM report 91 on X-ray equipment testing. Abstract IR(ME)R essentials This presentation will highlight the essential elements of the Ionising Radiation (Medical Exposure) Regulations, particularly those relevant to Radiology. Questions on IR(ME)R are a regular occurrence in the Physics paper in Part 1 of the FRCR examination. Therefore the material for this presentation has been selected to answer common questions in the MCQ. Particular emphasis will be placed on the issues involved with justifying a medical exposure.
Education Aims:
To provide refresher training on the Ionising Radiation (Medical Exposure) Regulations, in order to aid revision and, where necessary, highlight any deficiencies in knowledge.
Learning Outcomes:
Understand the general requirements of the regulations
Appreciate the issues involved with justifying and authorising a medical exposure
Biography Dr Lorna Sweetman, Clinical Scientist, 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. Abstract
Computed tomography 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
Biography
Mr Stephen Russell, Principal Physicist, The Christie NHS Foundation Trust Stephen 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. 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 Abstract
Ultrasound Learning objectives:
An over view of the current curriculum
An understanding of the generation of an ultrasound B-mode image
An understanding of the different ultrasound probe types and how they function
An understanding of the formation of harmonic signals in tissue and how systems image them
Contrast media and enhanced images
An overview of ultrasound system safety
Biography Dr Anthony Hughes, Medical Physicist, Royal Preston Hospital
Tony is a state registered Medical Physicist with 20 years clinical experience in clinical nuclear medicine, with a further 7 years 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 6 years has been an examiner for the Institute of Physics & Engineering in Medicine (IPEM) Part 1 training scheme. He currently sits on the Royal College of Radiologists First FRCR Examination Committee (Physics). Abstract Nuclear medicine This talk will review the basic science of nuclear medicine imaging including the following topics: 1. The design & operation of the gamma camera a. The collimator b. NaI crystal c. PM tubes & pulse processing 2. Factors affecting patient dose & image quality a. Injected activity b. Effective half-life c. Spatial resolution, contrast & noise 3. Radiation protection considerations for patients a. Conception b. Pregnancy c. Breastfeeding 4. Additional legislative requirements for nuclear medicine a. EPR 2010 b. MARS 1978 5. Physics of SPECT imaging a. Detector requirements b. Factors affecting image quality 6. Physics of PET imaging a. Coincidence detection b. Block detectors & scanner design c. FDG scanning d. 2D & 3D acquisitions
e. Factors affecting image quality Biography Professor Andrew Jones, Consultant Clinical Scientist, The Christie NHS Foundation Trust Andrew is a Consultant Clinical Scientist within Christie Medical Physics and Engineering at The Christie, Manchester and is Group Leader for Non-ionising Imaging. The groups MR section provides scientific support to MRI users across the North West region. He is a frequent lecturer covering a variety of subjects within clinical MRI. Andrew is currently President of the BIR. Abstract MR physics
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
Our platinum sponsors
GE Healthcare provides transformational medical technologies and services to meet the demand for increased access, enhanced quality and more affordable healthcare around the world. GE (NYSE: GE) works on things that matter - great people and technologies taking on tough challenges. From medical imaging, software & IT, patient monitoring and diagnostics to drug discovery, biopharmaceutical manufacturing technologies and performance improvement solutions, GE Healthcare helps medical professionals deliver great healthcare to their patients.
Philips is a diversified health and well-being company and a world leader in healthcare, lifestyle and lighting. Our vision is to make the world healthier and more sustainable through meaningful innovation. We develop innovative healthcare solutions across the continuum of care, in partnership with clinicians and our customers to improve patient outcomes, provide better value, and expand access to care. As part of this mission we are committed to fuelling a revolution in imaging solutions, designed to deliver greater collaboration and integration, increased patient focus, and improved economic value. We provide advanced imaging technologies you can count on to make confident and informed clinical decisions, while providing more efficient, more personalised care for patients.
The Siemens Healthcare sector is one of the world’s largest suppliers to the healthcare industry and a trendsetter in medical imaging, laboratory diagnostics, medical information technology and hearing aids. Siemens offers its customers products and solutions for the entire range of patient care from a single source – from prevention and early detection to diagnosis, and on to treatment and aftercare. By optimising clinical workflows for the most common diseases, Siemens also makes healthcare faster, better and more costeffective. For further information please visit: /www.siemens.co.uk/healthcare
FORTHCOMING EVENTS
Radiology errors 31 January 2014 London
Scottish Branch meeting: Recent advances in diagnostic imaging 14 February 2014 Glasgow
3rd Annual SPECT/CT symposium: Current status and future directions of SPECT/CT imaging 24 February 2014 London
Multi-parametric imaging of prostate cancer can it facilitate a paradigm shift in management? 28 February 2014 London
Biological optimisation of radiotherapy 13 March 2014 London
Paediatric body MRI course 1 April 2014 London
Management and radiology - a guide to current and future management issues in radiology
2 May 2014 London
Radiotherapy - meeting the current and future workforce challenges for patient care in a changing context 19 May 2014 London
Molecular radiotherapy dosimetry 4 June 2014 Oxford
VISIT: WWW.BIR.ORG.UK FOR MORE INFORMATION AND TO REGISTER!
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