Module information

Module details

Title
Advanced Ultrasound and Optical Radiation Safety
Type
Specialist
Module code
S-IN-S3
Credits
10
Phase
3
Requirement
Compulsory

Aim of this module

The aim of this module is to provide trainees with workplace experiences and underpinning knowledge in advanced ultrasound. In the workplace trainees will provide specialist support in the application of advanced ultrasound techniques in healthcare, including equipment management and training in ultrasound physics. The module also includes complementary skills and knowledge in optical radiation safety.

Work-based content

Competencies

# Learning outcome Competency Action
# 1 Learning outcome 3,5 Competency

Advise on the procurement, decommissioning, maintenance and redeployment of ultrasound equipment

Action View
# 2 Learning outcome 1,3,4,5 Competency

Assess a scanner and/or transducer with a fault and draft a plan for repair and/or mitigation of the issue

Action View
# 3 Learning outcome 6,7 Competency

Deliver training on ultrasound principles and safety

Action View
# 4 Learning outcome 1,3,4 Competency

Perform acceptance testing and quality assurance on a range of specialist ultrasound scanners and transducers to include:

  • Echocardiography
  • Brachytherapy/urology
  • Bladder scanners
  • Point of care ultrasound (POCUS)
  • Breast screening with elastography
  • Trans-oesophageal echocardiogram (TOE)
Action View
# 5 Learning outcome 1,2,3 Competency

Perform assessment of elastography to include imaging and non-imaging systems, report the finding and deliver appropriate advice to clinical users

Action View
# 6 Learning outcome 1,3 Competency

Carry out output and dose calibration of a diagnostic scanner and for at least one of the following therapeutic devices:

  • Physiotherapy
  • Lithotripsy
  • HiFU
  • Lipus
Action View
# 7 Learning outcome 1,6 Competency

Design and construct an in-house phantom for QA or training

Action View
# 8 Learning outcome 1,3 Competency

Perform quality assurance of the doppler modes on a vascular system

Action View
# 9 Learning outcome 1,2,3 Competency

Critically appraise an advanced ultrasound technique or technology and the clinical applications for at least one of the following:

  • Elastography
  • Contrast enhanced ultrasound (CEUS)
  • High intensity focused ultrasound (HIFU)
  • Photo acoustics
  • 3D ultrasound tomography
Action View
# 10 Learning outcome 8 Competency

Analyse the accuracy and clinical relevance of output measurements, for both:

  • Non-coherent optical radiation sources
  • Coherent optical radiation sources
Action View

Assessments

Complete 2 Case-Based Discussions

Complete 2 DOPS or OCEs

Direct Observation of Practical Skills Titles

  • Perform quality assurance of an advanced imaging probe.
  • Perform a power output measurement on a diagnostic scanner.
  • Measure the output of an optical treatment source.

Observed Clinical Event Titles

  • Report the results of investigation of a fault in an ultrasound or optical equipment to a clinical governance meeting.
  • Advise on an ultrasound scanner repair.
  • Provide training using an in-house phantom.
  • Deliver an ultrasound/optical physics training session.

Learning outcomes

# Learning outcome
1

Use ultrasound scanners, applying basic and advanced modality controls.

2

Interpret clinical ultrasound images.

3

Assess the performance and safety of ultrasound scanners used in common clinical applications, including advanced imaging techniques.

4

Appy image processing techniques to extract information from ultrasound images.

5

Plan the management of ultrasound equipment in a healthcare setting.

6

Deliver training to other clinical or non-clinical staff about principles of ultrasound and ultrasound safety.

7

Critically appraise the clinical application of emerging ultrasound techniques.

8

Assess the performance and safety of optical radiation sources.

Clinical experiences

Important information

Clinical experiences help you to develop insight into your practice and greater understanding of your specialty. Clinical experiences should be included in your training plan and you may be asked to help organise your experiences. While Clinical Experiences are not assessed, reflections and observations from your experiences can be used to support evidence for competencies to demonstrate your awareness and appreciation of your specialty and it’s impact on patient care. You may find it helpful to capture thoughts from your experiences in your reflective log.

Activities

  1. Observe scans to appreciate the use of advanced modalities to appreciate the clinical application, parameters applied, clinical measurements ranges and protocols applied, patient/probe positioning, user set up and probe selection and the patient experience of scanning, for example echocardiography, brachytherapy/urology, bladder scanners, POCUS, breast screening with elastography and TOE.
  2. Attend a governance meeting where ultrasound and/or optical radiation protection issues are discussed to appreciate the process for managing risk and incidents.
  3. Observe therapeutic ultrasound treatment sessions for example; physiotherapy, lithotripsy, high-intensity focused ultrasound for surgery (HIFU) and low-intensity pulsed ultrasound for bone healing (LIPUS).
  4. Observe how complex non-coherent and/or laser sources are used in healthcare for treatment or diagnosis.
  5. Observe how doppler measurements are used for vascular diagnosis and patients’ treatment.
  6. Attend a clinical multidisciplinary team meeting where imaging is discussed in the content of patient clinical management.

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:

  1. Discuss the principles of advanced ultrasound and optical radiation investigation/therapeutic techniques for a range of clinical conditions, identifying associated risks, limitations and relevant guidance.
  2. Demonstrate a critical awareness of key factors in the specification, tendering, commissioning and life cycle management for ultrasound equipment.
  3. Critically evaluate complex performance measurements and advanced quality assurance of ultrasound equipment.
  4. Justify safety assessments for non-laser optical sources.

Indicative content

Ultrasound
Ultrasound – advanced methods Advanced B-mode ultrasound scanning: spatial and frequency compounding, coded excitation, real-time adaptive processing, sound-speed correction and auto-optimisation

CW and PW doppler ultrasound: CW doppler with phased array transducers, PW doppler with curved and linear array transducers, duplex doppler ultrasound systems, CW and PW signal processing

Colour doppler and power doppler imaging: colour doppler imaging for vascular, cardiac and other applications, and signal processing

B-mode and doppler measurement tools: B-mode calipers, ellipse and manual trace tools, Doppler calipers and auto-tracing tools, obstetric and cardiac calculation packages

B-mode and colour doppler image quality: spatial, temporal and contrast resolution, penetration, speckle, electronic noise, transducer element drop-out and other faults

Clinical doppler ultrasound: normal and pathological CW, PW and colour doppler appearances for abdominal, antenatal, cardiac and vascular applications

Tissue harmonic and contrast-enhanced ultrasound imaging: non-linear propagation of ultrasound in tissue, conventional and pulse inversion tissue harmonic imaging, characteristics of THI images, contrast-enhanced ultrasound and microbubble-based contrast agents

Elastography: static, strain and shear wave

Advanced quality assurance of ultrasound scanners: advanced tissue-mimicking phantoms e.g. in-house designed, spherical cyst and other phantoms, IPEM Reports, breast screening, brachytherapy and bladder scanners

Transducer repair and electronic transducer testing: to include testing devices and third party repair companies

Therapeutic ultrasound: physiotherapy ultrasound, lithotripsy, HIFU and LIPUS

Standards: for example, IEC 60601-1, IEC 60601-2-5, IEC 60601-2-37, USA FDA regulations, the medical device regulations etc

 Ultrasound – specifying and commissioning a system Considerations in specifying a system, familiarisation with tendering principles, assessing component performance, acceptance testing and fault findings
Image display Hard and soft copy display systems and QA of imaging display systems
Optical Radiation
Advanced biophotonics and microwave imaging Advanced biophotonics and applications: state-of-the-art overview – tailored to clinical applications; the future of biophotonics

Microwave Imaging: essentials of microwave measurements and imaging

Lasers – therapeutics Ophthalmology: Excimer, Argon and Nd-YAG, fempto second lasers construction, fibre optic beam delivery, mode locking, reflection of light from patient, and safety in theatre and clinic.

ENT, general surgery and urology: CO2, Holmium, KTP lasers, construction, beam delivery, focused hand pieces, lens construction, and measurement for measurement of heating profiles

Topical lasers and IPLs: review of sources, hair removal and cosmetic applications, physiotherapy applications, basis for treatment protocols and voluntary standards for the aesthetic sector, and safety aspects

Lasers and intense light sources in photo-dynamic therapy: Theory of action; physics of light delivery and efficacy within tumours, selection of light sources and delivery systems, light dosimetry and quality assurance, context of PDT within modern cancer treatment

Laser applications to image burn depths: potential for imaging using lasers, burn depth imaging, doppler imaging, and medical uses and application of holography

RF and microwave ablation Theory of action and clinical applications
UV phototherapy of skin diseases Nature of diseases: biophysical basis of phototherapy, irradiation apparatus, patient dosimetry and safety
Advanced non laser Safety Hazards of ultraviolet, visible, and infrared non laser optical sources in healthcare. ICNIRP exposure limit values, risk assessment and exposure measurements, and practical guided assessments

 

Module assigned to

Specialties

Specialty code Specialty title Action
Specialty code SPE1-2-22 Specialty title Imaging with Non-Ionising Radiation [2022] Action View