Imaging with Ionizing Radiation 2

Module details

Title

Imaging with Ionizing Radiation 2

Type

Specialist

Module code

SPE152

Credits

30

Requirement

Compulsory

Aim of this module

This module provides the trainee with the knowledge that underpins the specialist rotation in Imaging with Ionising Radiation in the third year of the MSc.

Radiopharmacy

The trainee has a detailed understanding of requirements for the safe production of radiopharmaceuticals, including quality systems, and can advise on radiation safety requirements and regulatory compliance for the radiopharmacy.

Diagnostic Radiology: Image Optimisation and Patient Dose  Measurement

To enable the trainee to undertake the assessment of patient dose and image quality in order to implement interventions for the optimisation of a range of imaging systems.

Radiation Protection

The trainee can, under supervision from a radiation protection adviser, advise on the radiation safety requirements for nuclear medicine and diagnostic radiology facilities

Information and Communication Technology

To enable the trainee to support the information and communication technology (ICT) infrastructure in diagnostic  imaging departments.

Submodules

Learning outcomes

1. Explain and evaluate the processes behind the safe production of radiopharmaceuticals.
2. Discuss and evaluate a range of non-imaging nuclear medicine studies.
3. Discuss appropriate image analysis/quantification techniques.
4. Design safe radiation environments that meet the requirements of legislation and guidance.
5. Describe the delivery of unsealed source therapy.
6. Discuss and critically appraise the commissioning and quality assurance of radiographic and nuclear medicine equipment.
7. Describe and critically appraise the IT environment in which radiographic and nuclear medicine equipment operates.

Indicative content

Radiopharmacy Manufacture and Production

• Production of radiopharmaceuticals, including PET
• Principles and operation of cyclotrons and automated radiochemistry for PET
• Radiopharmaceutical practice
• Internal dosimetry of radiopharmaceuticals, including practical methods of calculating radiation dose to patients and staff in emergency situations
• Non-imaging nuclear medicine techniques

Clinical

• Results from analyses (e.g. qualitative, quantitative) and the context in which they were acquired for nuclear medicine and complex diagnostic radiology techniques
• Limitations of applied acquisition and analysis protocols as this relates to interpretation
• Physiological and pathological processes giving rise to image findings
• The consequences of the result of the procedure to the patient’s overall clinical management, particularly in relation to radiotherapy and radiotherapy treatment planning 

Image Display

• Hard copy and soft copy display systems
• External factors affecting image displays
• Quality assurance of image display systems
• Image perception 

Radiation Protection Specific to Diagnostic Facilities

• Measurement and calculation of patient doses
• Optimisation
• Design of facilities
• Shielding calculations
• Cyclotrons and radionuclide production facilities
• Environmental monitoring
• Population exposures
• Radioactive source transport and waste disposal
• Accident procedures and emergency planning 

Unsealed Source Treatments

• The scientific basis and radiobiology of the use of radioactive materials for radiotherapy
• Unsealed source treatments, including preparation, administration, protection arrangements and decontamination
• Uptake, planning and dosimetric calculations

Technical

• The requirements of equipment for calibration/QA, both generally and specific to each application
• Appropriate methods for data reconstruction, pre-processing (e.g. registration, smoothing) and analysis (e.g. region of interest, curve generation)
• Imaging techniques in radiotherapy (portal imaging, megavoltage imaging, cone beam CT and simulation
• Gated and time sequence imaging
• The commissioning process for new equipment with reference to:
  • gamma cameras, including SPECT/CT
  • PET/CT
  • diagnostic radiology equipment
  • the critical examination
• IT and networking
  • nuclear medicine workstations
  • image analysis software
  • PACS
  • specialist patient management systems, e.g. cardiology systems
  • networking and the network environment
  • system management, configuration control and software release
  • interoperability, DICOM RT, HL7 and messaging standards
  • links to hospital administration systems
  • legislative framework for IT, data protection
  • regulatory standards including IEC601 and the Medical Devices Directive as applied to software

Activities

Radiopharmacy

• Observe and review a monitoring programme (e.g. environmental, microbiological, product quality control) and reflect/report on its importance both for service delivery and for patient safety.
• Critically review one or several aspects of the quality system in terms of its effect on service delivery and patient safety.
• Perform an audit of regulatory compliance against legislation concerning the use of radioactivity.
• Conduct a training exercise for simulated radioactive liquid spills, monitor the exercise and report on its effectiveness, the implications of inappropriate or untimely response and the knock-on effect on patients, staff and public (optional).
• Conduct a radiation dose review for staff in the radiopharmacy, and report and present to colleagues with your proposals for improvement (optional).
• Discuss the role of the quality system in assuring the quality of radiopharmaceuticals (optional).

Diagnostic Radiology: Image Optimisation and Patient Dose  Measurement

• Identify a patient who has been referred for diagnostic imaging imaging investigation and, with permission, devise an investigation strategy for the optimisation of image quality against patient doses taking account of the clinical need. Reflect, review and discuss in terms of the effectiveness of the strategy and patient needs, experience and care, and demonstrate knowledge and understanding relating to competences associated with calculating patient dose reduction.

Radiation Protection

• Take part in a local radiation protection committee meeting and reflect on the way the multidisciplinary team contributes to the safety of patients, staff and the public in areas in which radiation is used.
• Attend a meeting at which the outcome of a clinical audit, research, innovation or service development is presented and discuss with your training supervisor how evidence-based practice is implemented with respect to radiation safety.
• Observe a series of patients receiving treatment or investigations involving radiation, with permission, and critically appraise the process and the implications for effective radiation safety.
• Plan a simulated radiation incident and the responses/action required across a multidisciplinary team. Review and discuss with your supervisor, including the implications of incident for patients, staff and the public, internal and external standards, guidance and procedures, possible improvements in current practice and the impact on your own future practice.

Information and Communication Technology

• Identify a clinical application for which a new software solution would improve both service delivery and patient outcome experience, develop specification and prototype, and discuss and review with your supervisor.
• Based on your experience, critically appraise the existing imaging system ICT structure and make evidence-based recommendations  for improvements.
• Validate a new piece of software following a system upgrade.