Module information
Module details
- Title
- Image Acquisition, Processing and Clinical Application
- Type
- Specialist
- Module code
- S-IN-S1
- Credits
- 20
- Phase
- 2
- Requirement
- Compulsory
Aim of this module
The module aims to provide trainees with the knowledge and skills required to work with non-ionising radiation including MRI, ultrasound and optical radiation. Trainees will assess the safety and performance of equipment in the clinical environment, the application of common parameters and manipulate and process clinical images.
Work-based content
Training activities
| # | Learning outcome | Training activity | Type | Action |
|---|---|---|---|---|
| # 1 | Learning outcome 1 |
Training activities
Design and perform a comprehensive safety audit of an MRI scanner suite and its associated local rules, report the findings and make recommendations where necessary |
Type DTA | Action View |
| # 2 | Learning outcome 1, 2 |
Training activities
Perform a risk assessment of a clinical ultrasound setting |
Type DTA | Action View |
| # 3 | Learning outcome 2 |
Training activities
Create a workflow map of the clinical MRI service in the department, highlight the pulse sequences used for investigation of routine clinical examinations for a range of body parts, and why particular sequences are chosen to answer each clinical question |
Type DTA | Action View |
| # 4 | Learning outcome 2 |
Training activities
Identify normal and pathological features for a range of routine ultrasound examinations
|
Type DTA | Action View |
| # 5 | Learning outcome 3 |
Training activities
Perform, analyse and report a range of quality control/assurance tests to assess MR scanner performance and make recommendations for faults identified |
Type ETA | Action View |
| # 6 | Learning outcome 3,5 |
Training activities
Perform, analyse and report routine quality assurance for B-mode on a range of clinical ultrasound scanners:
|
Type ETA | Action View |
| # 7 | Learning outcome 4 |
Training activities
For all basic MR pulse sequences, investigate experimentally the effects of the key user-controllable parameters on the resulting image quality, acquisition time contrast, coverage, resolution, and SNR |
Type DTA | Action View |
| # 8 | Learning outcome 1, 4 |
Training activities
Investigate the effects of user selectable parameters applied during scanning on the resulting image quality, contrast, resolution and safety indices for a range of routine US B-mode pre-sets |
Type DTA | Action View |
| # 9 | Learning outcome 1, 4 |
Training activities
Investigate the effects of user selectable parameters for:
|
Type DTA | Action View |
| # 10 | Learning outcome 5 |
Training activities
Identify a range of MRI artefacts and their causes. Demonstrate modifications to the acquisition protocol, hardware and/or reconstruction which reduce or eliminate them |
Type DTA | Action View |
| # 11 | Learning outcome 5 |
Training activities
Identify a range of B-mode and doppler ultrasound artefacts and their causes. Demonstrate how the choice of control settings and transducer manipulation can reduce or eliminate them where necessary |
Type DTA | Action View |
| # 12 | Learning outcome 6 |
Training activities
Research and design a phantom for quality assessment of an MRI or hybrid-modality scanner |
Type DTA | Action View |
| # 13 | Learning outcome 4 |
Training activities
Vary the MR pre-scan and reconstruction parameters to demonstrate the effect on MR image quality, to include:
|
Type DTA | Action View |
| # 14 | Learning outcome 7 |
Training activities
Write, validate and document software to manipulate DICOM image headers, including anonymisation |
Type DTA | Action View |
| # 15 | Learning outcome 7 |
Training activities
Investigate different methods to register two image datasets |
Type DTA | Action View |
| # 16 | Learning outcome 7 |
Training activities
Investigate different methodologies, including artificial intelligence techniques, to segment features from an image |
Type DTA | Action View |
| # 17 | Learning outcome 7 |
Training activities
Develop, validate and document software to analyse images |
Type DTA | Action View |
| # 18 | Learning outcome 1, 4 |
Training activities
Measure acoustic output of physiotherapy and/or other therapeutic ultrasound equipment |
Type DTA | Action View |
| # 19 | Learning outcome 7 |
Training activities
Set up and test a DICOM link between two nodes. Send, query and retrieve DICOM instances to/from a remote host |
Type DTA | Action View |
| # 20 | Learning outcome 1 |
Training activities
Design and perform comprehensive safety audits of areas where optical radiation is used, including:
|
Type DTA | Action View |
Assessments
Complete 4 Case-Based Discussions
Complete 4 DOPS or OCEs
Direct Observation of Practical Skills Titles
- Perform a routine MRI quality assurance test.
- Perform a routine B-mode or doppler ultrasound quality assurance test.
- Perform acoustic output measurements for diagnostic or therapeutic ultrasound devices.
- Use magnetometer to plot 3mT and 0.5mT contours.
- Screen MR equipment using a test magnet.
- Perform a risk assessment of an optical source.
Observed Clinical Event Titles
- Discuss the results of a quality report with another healthcare professional.
- Discuss a strategy to reduce the impact of an artefact with another healthcare professional.
- Discuss the results of a safety audit or risk assessment and how to implement findings with another healthcare professional.
Learning outcomes
| # | Learning outcome |
|---|---|
| 1 | Assess the safety of the clinical application of non-ionising radiation. |
| 2 | Interpret routine MR and ultrasound images and advise on the choice of scanning parameters. |
| 3 | Perform and report on the basic performance of MRI and ultrasound scanners. |
| 4 | Acquire MR and ultrasound images and apply appropriate user-controllable parameters. |
| 5 | Identify ultrasound and MRI artefacts and advise on parameters to mitigate the impact on clinical images. |
| 6 | Design a phantom for quality assessment. |
| 7 | Manipulate and analyse medical images and metadata. |
Clinical experiences
Clinical experiences help you to develop insight into your practice and a greater understanding of your specialty's impact on patient care. Clinical experiences should be included in your training plan and you may be asked to help organise your experiences. Reflections and observations from your experiences may help you to advance your practice and can be used to develop evidence to demonstrate your awareness and appreciation of your specialty.
Activities
- Observe a range of clinical MRI scans to appreciate the clinical application, safety screening, parameters applied, clinical measurements ranges and protocols applied, patient/probe positioning, and set-up, user interactions and patient experience of scanning. For example: brain, spine, musculoskeletal, joints, cardiovascular, abdominal, and pelvic MRI.
- Observe a range of clinical ultrasound scans, for example: general radiology, obstetrics, cardiology, MSK, vascular, neonatal, and breast to appreciate the clinical application, parameters applied, patient/probe positioning, user set up and probe selection and the patient experience of scanning.
- Observe the therapeutic application of non-ionising radiation, for example: MED therapy and PDT therapy.
- Attend governance meeting where a non-ionising radiation incidents are discussed to appreciate the role of management of organisation wide risk.
- Discuss reporting procedures with a radiologist to appreciate image features and image quality required to answer the diagnostic question confidently.
Academic content (MSc in Clinical Science)
Important information
The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.
Learning outcomes
On successful completion of this module the trainee will be able to:
- Explain the operation of complex non-ionising radiation equipment, identifying associated risks and limitations.
- Critically evaluate specialist image acquisition techniques and imaging processing methods to segment and register images.
- Identify and explain common MR and ultrasound image artefacts.
- Critically appraise the advantages and disadvantages of MRI and ultrasound in common clinical conditions.
- Critically appraise safety requirements for optical radiation hazards.
- Discuss information technology, networking, and governance in relation to the non-ionising radiation.
Indicative content
| MR | |
| MR – advanced NMR | Extending knowledge to a detailed mathematical analysis. T1, T2, Measurement of relaxation (CPMG, IR, Saturation recovery) |
| MR – advanced image formation | Mathematics of k-space, Phase Encoding, K vs FOV vs Res, Sampling theory and aliasing, Bandwidth and Gradient strength, Slice Selection, Small tip angle approximation, slice profile, crusher gradients, limits on resolution. |
| MR – advanced imaging | Advanced pulse sequences: TSE, EPI, GRASE, FISP, advanced readouts, Low flip refocused TSE, Relaxometry, Dynamic acquisitions, Parameter selection.
Selection of scan parameters and influence on performance. Trade-offs in MRI scanning (Speed, Resolution, SNR). Coherence: Physics of coherence formation, Gradient and RF spoiling, FOV restriction, Flow Compensation. Parallel imaging: Speed up techniques, reconstruction, artefacts. Processing: FFT processing, K-space filtering |
| MR – advanced instrumentation | Magnet types, Gradient and Shim Design (shielded), Linearity, RF coil designs, Resonant circuits, Pre-amps, Digital Sampling, Distortion effects, Slice profiles, Gradient Trapezoids, Eddy currents and Pre-emphasis, Dielectric resonance. |
| MR – physics of image artefacts | CS artefacts (and their control/minimisation), FISP, Motion, Parallel Imaging Factors, Off-resonance, Motion and gating, zippers. |
| MR – clinical features of MRI | Normal and pathological appearances on MRI – Example cases from brain and body. Effect of field strength on image contrast. |
| Ultrasound | |
| Ultrasound – Physics and technology | Piezoelectricity and ultrasound transducers: the piezoelectric effect, ceramic and composite piezoelectric materials, matching and backing layers, single-element and multi-element transducers, frequency response, ultrasound fields produced by simple transducers.
Array transducers for real-time imaging: array transducer geometries, ultrasound fields produced by array transducers, rectangular apertures, 2D array transducers for cardiac and abdominal imaging. Beam forming: array transducer focusing and steering, side lobes and grating lobes, apodisation, multiple transmit focusing, dynamic receive focusing. B-mode physics: speed of sound in tissues, attenuation in tissues, ultrasound image formation, frame rate, speckle and noise. Doppler physics: the doppler effect and equation, speed of sound and scattering in blood, blood flow in arteries, CW doppler spectra, standalone doppler systems. |
| Ultrasound – Practical scanning and quality assurance | Intermediate B-mode scanning: B-mode scanner controls, e.g. depth, focus, transmit frequency, output, gain, TGC and post-processing.
Clinical B-mode applications: normal and pathological B-mode appearances for abdominal, antenatal, echocardiography and vascular applications. Quality assurance: intermediate B-mode quality assurance, measurement of noise levels, testing using commercial tissue-mimicking phantoms (e.g. penetration and spatial resolution), basic Doppler testing. Output measurements: measurement of pressure, intensity and total acoustic power; checking displayed values of thermal and mechanical index. Doppler scanner controls: CW and PW. Ultrasound artefacts: B-mode, colour, CW and PW. Ultrasound measurements and their errors. |
| Hybrid imaging | CT-ultrasound and MRI-ultrasound fusion imaging |
| Ultrasound – safety in detail | Relevant guidelines (e.g. AIUM, BMUS and EFSUMB) for B-mode, doppler and contrast-enhanced ultrasound; NHS FASP and BSP requirements etc. |
| Optical Radiation | |
| Non-Laser optical radiation in healthcare | Diagnostic light sources, laboratory and disinfecting light sources, UV phototherapy, Blue Light therapy, Red light photodynamic (PDT), Dental curing lights, and other new emerging technologies. |
| Advanced VIS-IR light-UV techniques for diagnostics and imaging | Laser Speckle and Doppler, Optical coherence tomography (OCT). NIR, Fluorescence and Raman spectroscopy, Diagnostic phototesting |
| Clinical Uses of IR and imaging | Measurement of tissue oxygen content and the micro-circulation |
| Lasers in clinical assessment and treatment | Laser and intense light theory and devices: essential theory, ruby laser, gas laser, argon, Nd-Yag; Cu-vapour, CO2, Pumped dye laser, solid state laser, excimer. He-Ne, LED devices, clinic lamps, theatre lights, fluorescent lamps.
Thermal and non-thermal tissue interactions: basic theory including some equations but limited in treatment. Power measurement and laser delivery systems: use of power meters, integrating spheres, etc. Delivery systems including fibre and articulated arm systems, issues surrounding numerical aperture. |
| Safety | UV: UV spectrum; solar radiation; artificial production of UV, hazards of UV; radiometric terms and units; radiometric calculations; spectroradiometry; narrow band radiometry; broad band radiometry; personal UV dosimetry, ICNIRP guidelines and exposure limits.
Lasers: BSI manufacturing standards; accessible emission limits; nominal optical hazard distance; CE marking; MHRA guidance; regulations; local rules; risk assessments; routine checks; duty holders and responsibilities; practical tips. |
| Imaging with Non-ionising Radiation | |
| Modality choice | Advantages and disadvantages of MRI or ultrasound in a range of clinical applications |
| IT and networking | Health Informatics: Networking and the networking environment; systems (PACS, hospital administration systems, specialist patient management systems, image acquisition and image workstations); interoperability (DICOM, HL7, messaging standards); workflows (order comms, IHE). Non-linear nature of visual perception and DICOM Greyscale Display Function.
Governance in health informatics: Legislative framework for IT; data protection and related guidelines; system management (configuration, admin, software release); regulatory standards as applied to software. Software development: good coding practice, quality management, information governance |
| Image processing | Segmentation: segmentation methods (manual, edge based, contrast); Neural networks.
Registration: Registration methods (Rigid, affine and non-rigid) and registration metrics; Multi-modality registrations; motion correction. |
Module assigned to
Specialties
| Specialty code | Specialty title | Action |
|---|---|---|
| Specialty code SPE1-2-22 | Specialty title Imaging with Non-Ionising Radiation [2022] | Action View |
| Specialty code SPE1-2-23 | Specialty title Imaging with Non-Ionising Radiation [2023] | Action View |
| Specialty code SPE1-2-24 | Specialty title Imaging with Non-Ionising Radiation [2024] | Action View |