Study-Unit Description

Study-Unit Description


CODE MPH3008

 
TITLE Medical Physics and Radiation Protection in Diagnostic and Interventional Radiology and Dentistry (Minor)

 
UM LEVEL 03 - Years 2, 3, 4 in Modular Undergraduate Course

 
MQF LEVEL 6

 
ECTS CREDITS 5

 
DEPARTMENT Medical Physics

 
DESCRIPTION This study-unit applies what was learned in the previous core units to the specialty of Diagnostic and Interventional Radiology and Dentistry at a MINOR level. It will lay the groundwork for students to be able to specialise in this area at Masters level. The unit includes both ionising (projection radiography, fluoroscopy, CT) and non-ionising (ultrasound and MRI) imaging modalities including interventional radiology systems. Owing to the proliferation of imaging devices for dental surgery the unit provides also an overview of these including cone-beam equipment. The unit follows the recommendations regarding core and specialist Diagnostic and Interventional Radiology and Dentistry expertise to be found in the EC documents 'European Guidelines on the Medical Physics Expert' and 'Requirements and methodology for recognition of Radiation Protection Experts'.

Study-unit Aims:

This study-unit aims to:
- Present the common imaging modalities used in D&IR and Dentistry and their variants, their use in the various applications of medical imaging, relative technical strengths and limitations, performance indicators, methods of optimization of use and quality control;
- Reinforce the frequency domain representation of images, Fourier transform, statistical description, autocorrelation, convolution integral and theorem and convolution filters;
- Review in detail the way that imaging device acquisition data is processed to facilitate the extraction of information, including knowledge based image analysis, pattern theory, deterministic image processing and feature enhancement, image segmentation, image registration and co-registration/fusion, limitations of image post-processing;
- Reinforce knowledge of bioeffects of ionising and non-ionising radiation and apply to patient, occupational and public safety in D&IR and Dentistry;
- Familiarise students with the details of dosimetric methods, dose surrogate quantities, dose audits and the methodology for the setting up of DRLs for the various procedures;
- Provide opportunity for the elaboration and discussion of the roles of designated MPE, RPE and RPO in D&IR and Dentistry.

Learning Outcomes:

1. Knowledge & Understanding
By the end of the study-unit the student will be able to:

- Discuss the common imaging modalities used in D&IR and Dentistry and their variants and their use in the various applications of medical imaging; including general indications and contra-indications for NM procedures and risk/benefit justification;
- Discuss the relative technical strengths and limitations of the various imaging modalities and their impact on image quality outcomes and diagnostic sensitivity and specificity, signal detection and psychophysical theories (ROC analysis etc);
- Discuss in detail the way that acquisition data is processed to facilitate the extraction of information: including knowledge based image analysis, pattern theory, deterministic image processing and feature enhancement, image segmentation, image registration and co-registration/fusion, limitations of image post-processing;
- Discuss in detail the DICOM standard for all modalities including the meaning of the terminology used in the DICOM header of images from the various modalities;
- Discuss ionising and non-ionising bioeffects and dose-effect relationships with respect to patient safety;
- Discuss the principles underpinning current referral criteria for D&IR and Dentistry procedures;
- Discuss in detail dosimetric methods, dose surrogates, dose audits and the methodology for the setting up of DRL for the various procedures;
- Discuss the special requirements with respect to occupational/public particularly in fluoroscopy;
- Discuss the roles of designated RPE and RPO in radiation safety in D&IR and Dentistry;
- Discuss the institutional framework for Quality Assurance (QA) activity and regulation in a D&IR and Dentistry departments;
- Discuss the principles of contingency planning and emergency procedures in D&IR/Dentistry;
- Define the specifications of a D&IR/Dentistry imaging device for tender purposes, generally and as tailored to particular clinical requirements;
- Discuss frequency domain representation of images, Fourier transform, statistical description, autocorrelation, convolution integral and theorem and convolution filters; and
- Discuss quantitatively the principles of imaging device performance assessment: linear systems theory, types of contrast (subject, image and display), unsharpness (LSR, PSF, LSF, MTF), lag, noise (sources, NPS, effect of lag on noise, noise propagation in image subtraction), SNR (including Rose model, Wagner’s taxonomy, CNR, relation to dose, NEQ, DQE, NPS etc).

For each imaging modality used in D&IR and dentistry:
- define the physical property which the device measures including variables impacting the value of these properties and tissue contrast;
- physics principles, geometry, functioning, structure, strengths and limitations, artefacts;
- discuss target imaging outcomes;
- device performance indicators;
- design for patient/occupational/public safety;
- protocol design variables which impact image quality and patient dose;
- use and risks of contrast media;
- acquisition;
- use of protective barriers, accessories and apparel; and
- key considerations for the design of a new facility (including waiting and resting rooms).

2. Skills
By the end of the study-unit the student will be able to:

For each D&IR and Dentistry modality:
- Extract quantitative data from images;
- Select appropriate phantoms/test tools to QC devices used in D&IR and Dentistry;
- Select appropriate instruments for patient / occupational / public safety related dosimetric measurements and calculations;
- Elicit information from DICOM file headers;
- Use appropriate statistical techniques to calculate uncertainties;
- Recognize normal physiology as well as pathology in images;
- Apply the concepts of justification and optimization;
- Apply local European/National laws, regulations, recommendations and standards related to patient/occupational/public safety;
- Classify appropriately radiation areas; and
- Take measurements to verify that occupational/public doses are in compliance with legislation.

Main Text/s and any supplementary readings:

Main
- IAEA. (2014). Diagnostic Radiology Physics - A Handbook for Teachers and Students.
- IAEA. (2010). Clinical Training of Medical Physicists Specializing in Diagnostic Radiology. Training Course Series 47.
- Martin, C. J. & Sutton, D. G. (2015). Practical Radiation Protection in Healthcare. OUP.
- McRobbie, D. W., Moore, E. A. & Graves, M.J. (2017). MRI from Picture to Proton. CUP.
- Hedrick, W. R. & Hykes D.L. (2004). Ultrasound physics and instrumentation. Elsevier-Mosby.
- Emerald-Emit Project. (2003). Prpject website: http://emerald2.eu/cd/Emerald2/

Supplementary
- Dendy, P. P. & Heaton, B. (2011). Physics for Diagnostic Radiology. Institute of Physics Publishing. CRC.
- Burzug, T. M. (2010). Computed Tomography: from photon statistics to modern cone-beam CT. Springer.
- Kalender, W. A. (2011). Computed Tomography. Publicis Press.
- Brown, R. B., Cheng, Y. N., Haacke, E. M., et al. (2014). Magnetic Resonance Imaging - Physical Principles and Sequence Design. Wiley.
- Elster, A. D. & Burdette, J. H. (2000). Questions and Answers in Magnetic Resonance Imaging. Mosby.
- Knoll, G. F. (2010). Radiation Detection and Measurement. Wiley.
- Del Guerra, A. (2004). Ionizing Radiation Detectors for Medical Imaging. World Scientific.

 
STUDY-UNIT TYPE Lecture, Independent Study & Tutorial

 
METHOD OF ASSESSMENT
Assessment Component/s Assessment Due Sept. Asst Session Weighting
Examination (3 Hours) SEM1 Yes 100%

 
LECTURER/S Maria Busuttil
Mona Lisa Camilleri
Eric Pace
Keith Schembri
Nolan Vella

 

 
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The availability of optional units may be subject to timetabling constraints.
Units not attracting a sufficient number of registrations may be withdrawn without notice.
It should be noted that all the information in the description above applies to study-units available during the academic year 2023/4. It may be subject to change in subsequent years.

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