A presentation give to the Southampton Hub of the Council for Allied Healthy Professions Research: http://www.southampton.ac.uk/ahprnhub/index.page. Learning objectives included: - Appreciation of the variety of modalities and techniques (ionising and non ionising) - Understanding of risks associated with medical imaging in research (incidental findings and ethical considerations)

1. USING MEDICAL IMAGING IN
YOUR RESEARCH
F I ONA ME L LO R
R E S E A RCH R ADI O G R A PHE R /NIHR C L INI C A L
AC ADEMI C F E L LOW
ANG LO - E U RO P E AN CO L L E G E O F CHI RO P R AC T I C .
B O U RNEMO U TH. U K

2. LEARNING OBJECTIVES
 Appreciation of the variety of
modalities and techniques
 (ionising and non ionising)
 Understanding of risks associated with
medical imaging in research
 (incidental findings and ethical
considerations)

3. DEFINITION
Medical imaging: the technique, process
and art of creating visual representations
of the interior of a body for clinical
analysis and medical intervention.
Medical imaging seeks to reveal internal
structures hidden by the skin and bones,
as well as to diagnose and treat disease
http://en.wikipedia.org/wiki/Medical_imaging

4. ‘DEPARTMENTS’
MODALITIES/PROFESSIONS AND TECHNIQUES
Radi-ology
Clinical
imaging
Ultrasound
Diagnostic
imaging
Radi-ography
Medical
Imaging
X-ray CT/MRI
PET/CT
Endoscopy
Nuclear
(unclear)
medicine
Isotope
scanning
Angiography
fMRI Breast
screening
Mammography
Fluoroscopy
Sonography
"An ology means you're a scientist“ Maureen Lipman 1980’s

5. IONISING OR NON IONISING

6. IONISING
 X Ray
Radiographs/
mammograms
 CT
 Fluoroscopy
 Nuclear
medicine

7. NON IONISING
 Ultrasound
(2D/3D/4D)
Doppler
Elastography
 MRI MRI sounds
fMRI/kinetic
MRI/contrast MRI

8. ETHICAL CONSIDERATIONS
IONISING RADIATION
FREE RESEARCHER TRAINING for IRAS form completion
http://www.hra.nhs.uk/hra-training/training/

9. ETHICAL CONSIDERATIONS
• Research involving or using ionising radiation or
injection of contrast media requires NRES approval:
• Clinical radiation expert (CRE) and medical
radiation expert (MRE) (registered Dr or dentist)
• Understanding of legislation/ guidelines (IR(ME)R
2000/ARSAC/IRR99)
• Estimation and communication of radiation dose
and potential risk
• Consideration of incidental findings (retrospective
and prospective)
• http://www.hra.nhs.uk/documents/2013/10/approval-of-research-involving-
ionising-radiation-2.pdf

10. INCIDENTAL FINDINGS
• How are they defined?
• Are participants
informed?
• Who interprets the
images and for what
reasons?
• Who pays for extra
treatment costs?
http://www.rcr.ac.uk/docs/radiology/pdf/BFCR(11)8_Ethics.pdf

11. SUMMARY
• Medical imaging is frequently used in research as
an outcome measure
• Research into new medical imaging techniques
and procedures (is it better than existing techniques?)
• Using ionising radiation or contrast agents will
require central NRES approval
• Using existing images will require departmental and
trust R&D approval
• The increased ethical considerations are based on
risk

12. QUESTIONS AND COMMENTS?

13. OTHER CONSIDERATIONS
• Prospective/retrospective studies and accessing
existing data
• Participant safety (metal objects such as aneurysm
clips and MRI)
• Operator dependency (ultrasound)
• Tolerance of the procedure
• Remuneration/service support costs
• Involvement of the imaging (radiologist and
radiographers) and medical physics department
from the very beginning