Imaging with Ionising Radiation

Module details

Title

Imaging with Ionising Radiation

Type

Rotation

Module code

SPE101

Credits

10

Requirement

Compulsory

Aim of this module

To introduce the trainee to a range of equipment and techniques used in Nuclear Medicine and Diagnostic Radiology and understand the effects of image acquisition parameters and post processing.

Competencies

#	Learning outcome	Competency	Action
# 1	Learning outcome 1	Competency Perform routine quality control measurements on gamma cameras, Single-photon emission computed tomography (SPECT/ Computed Tomography (CT)) scanners and Positron emission tomography (PET)/CT scanners if available.	Action View
# 2	Learning outcome 1	Competency Investigate the effects of acquisition parameters and post- acquisition processing and display on planar image. This should include planar, SPECT, SPECT/CT and/or PET/CT imaging if available.	Action View
# 3	Learning outcome 2	Competency Establish appropriate operating conditions for sample counters, including energy calibration and choice of energy.	Action View
# 4	Learning outcome 2	Competency Perform routine quality control measurements on sample counters and associated equipment, e.g. centrifuges.	Action View
# 5	Learning outcome 2	Competency Investigate the effect on measured count-rate of factors such as energy window setting, sample volume and source–detector geometry for in-vitro and in-vivo counters.	Action View
# 6	Learning outcome 2	Competency Prepare radioactive samples and standards for counting.	Action View
# 7	Learning outcome 2	Competency Assist in routine patient investigations using uptake counters, gamma spectrometers, manual and automatic beta and gamma sample counters correctly and safely, and, where possible, other equipment such as whole body counters demonstrating patient-centred, safe practice and the effect of equipment settings and counting geometry on measured count-rates.	Action View
# 8	Learning outcome 2	Competency Control of infection risks pre, during and post investigations and actions taken to manage these.	Action View
# 9	Learning outcome 2	Competency Analyse data from non-imaging tests to give quantitative physiological information.	Action View
# 10	Learning outcome 3	Competency Measure and record air pressures in the rooms of a radiopharmacy.	Action View
# 11	Learning outcome 3	Competency Perform QC testing of the Tc-99m generator eluate, including yield, radionuclide purity and chemical purity.	Action View
# 12	Learning outcome 3	Competency Prepare a technetium-99m	Action View
# 13	Learning outcome 3	Competency Measure the radiochemical purity of a technetium-99m labelled radiopharmaceutical.	Action View
# 14	Learning outcome 3	Competency Perform routine quality assurance measurements on a radionuclide calibrator.	Action View
# 15	Learning outcome 4	Competency Handle sealed and unsealed radioactive sources, demonstrating the application of the principles of time, distance and shielding to minimise radiation dose.	Action View
# 16	Learning outcome 4,5	Competency Operate a range of quality control equipment, including ionisation chambers, solid state dosimeter an electrometer and a kV meter.	Action View
# 17	Learning outcome 4,5	Competency Change image acquisition parameters and review the effect on the measurements made using quality control equipment.	Action View
# 18	Learning outcome 5	Competency Undertake cross-calibration of an ionisation chamber or solid state dosimeter.	Action View
# 19	Learning outcome 4,5	Competency Operate a basic range of radiographic and fluoroscopic X- ray equipment under supervision and perform quality assurance tests.	Action View
# 20	Learning outcome 4,5	Competency Undertake image quality tests on a radiographic or fluoroscopic system.	Action View
# 21	Learning outcome 5	Competency Measure the parameters of an automatic exposure	Action View
# 22	Learning outcome 6	Competency Undertake a patient dose audit and present the results, including reference to appropriate dose reference	Action View
# 23	Learning outcome 6	Competency Measure the performance characteristics of a dose area product meter against a calibrated reference ionisation chamber.	Action View
# 24	Learning outcome 6	Competency Measure or calculate patient doses for a range of examinations, including the estimation of foetal dose.	Action View
# 25	Learning outcome 6	Competency Calculate the risks and the risk factors associated with patient doses.	Action View

Assessments

You must complete:

• 1 case-based discussion(s)
• 1 of the following DOPS/ OCEs:

Carry out a centre of rotation test on a SPECT system	DOPS
Prepare samples and standards for GFR measurement	DOPS
Measure the radionuclide purity, molybdenum breakthrough, for technetium 99m eluate	DOPS
Draw up radioactivity and prepare phantom for QC studies	DOPS
Operate and perform QA measurements on a radiographic imaging system	DOPS
Undertake calibration check on a dose area product meter	DOPS

Learning outcomes

1. Demonstrate safe practice when working with sources of ionising radiation, including X-ray equipment, sealed and unsealed radioactive material.
2. Assist in routine patient investigations using uptake counters, gamma spectrometers, manual and automatic beta and gamma sample counters correctly and safely, and, where possible, other equipment such as whole body counters, demonstrating patient-centred, safe practice and the effect of equipment settings and counting geometry on measured count-rates.
3. Perform a range of procedures in the radiopharmacy correctly and safely, including quality assurance tests of facilities, products, equipment and radionuclide calibrators.
4. Handle sealed and unsealed radioactive sources safely and use safe practice when working with X-ray equipment.
5. Operate radiographic and fluoroscopic equipment for the purpose of performance testing and undertake performance tests on a basic range of X-ray equipment.
6. Make and collate patient dose measurements, calculating patient doses for a range of examinations, including the calculation of foetal dose.

Learning outcomes

1. Describe the legislation that applies to safe working within the radiation, workshop and clinical environments. 
2. Explain the physical principles behind the interaction of radiation with matter.
3. Describe the basis of clinical measurement. 
4. Discuss and evaluate the role of Medical Physics in innovation and service development.

Indicative content

• The physics and mathematics of image formation with ionising radiation as it relates to:
  • the radiological image
  • computerised tomography (CT) scanning
  • nuclear medicine
  • positron emission tomography (PET)
• Introduction to image reconstruction techniques
• Introduction to image processing and analysis
• Image display characteristics
• Clinical application and a basic understanding of normal and pathological appearances within the image
• Introduction to image registration
• Quality assurance

Information and Communication Technology (ICT)

• The range of general purpose computer software in common use, including spreadsheets, flat-file and structured databases, online reference and collaborative resources
• An understanding that computing applied clinically involves additional safeguards when ‘the computer acts as a clinical device’, including an understanding of the role of the Medicine and Healthcare products
• Regulatory Agency (MHRA), the Food and Drugs Administration (FDA) and the International Electrotechnical Commission (IEC) and their role in CE Marking
• An introduction to the concept of the software life cycle and the tools and frameworks used to specify, develop, validate and verify clinical software
• The basic principles relating to Information and Communication Technology (ICT) security, including firewalls, virus protection, encryption, server access and data security
• Information Governance, including NHS security policies
• The need for data exchange standards and be aware of some of the common standards, e.g. Digital Imaging and Communications in Medicine (DICOM) and Healthcare Level 7 (HL7)
• The networking systems in common clinical use and be aware of the relevant local trust information technology policies
• The basic principles of applicable legislation and of local policies, including the Data Protection Act, Computer Misuse Act and Freedom of Information Act

Activities

• Observe and describe a range of common nuclear medicine scans, undertake analysis of the results and discuss with your training officer how the clinical scans contribute to the diagnosis and management of patients
• Observe and participate in the performance of a range of non-imaging in-vivo and in-vitro tests, including measurements of volume, uptake and clearance, and discuss the evidence base underpinning these procedures with your training officer
• Observe the routine production of radiopharmaceuticals and participate in routine quality assurance procedures within the radiopharmacy and describe the role of the radiopharmacy in patient care
• Participate in the performance assessment of a range of common X-ray imaging equipment and discuss the evidence base underpinning these measurements with your training officer
• Audit and calculate patient doses from a range of procedures and discuss the evidence base underpinning these calculations with your training officer