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  1. 1. MEDICAL IMAGING COURSE SYLLABUS Module 1 – Magnetic Resonance Imaging and Spectroscopy 2-4 November 2009 Sutton Campus of the Royal Marsden Hospital and Institute of Cancer Syllabus: • Basis of NMR • Relaxation Parameters and Spin Echoes • Magnetic Field Gradients, Slice selection and Frequency Encoding; • 2-D FT Imaging, k-space • Basic Imaging Sequences: Spin-echo and gradient echo • Hardware – RF Requirements and RF Coils • MRI in Practice • Image Artefacts • Safety Considerations • Introduction to in vivo MR Spectroscopy • Single-voxel MRS • Introduction to Spectroscopy Imaging (CSI) • Processing MRS Data • Flow and Angiography • Advanced Pulse Sequences and Techniques • Clinical applications of MRI Faculty: Dr S J Doran University of Surrey Mr M Graves Addenbrookes Hospital, Cambridge Professor D Lurie Head of Magnetic Resonance Research Group, University of Aberdeen Dr G Charles-Edwards Guy’s and St Thomas’s Hospitals Dr P Murphy R&D, GlaxoSmithKline, Uxbridge, Middx Dr G S Payne ICR and RMH, Sutton Dr W Vennart Pfizer R&D, Sandwich, Kent Dr C Messiou ICR and RMH, Sutton
  2. 2. Module 2 – Image Theory, perception and processing 24 November 2009 (1 day) Sutton Campus of the Royal Marsden Hospital and Institute of Cancer Research This course is repeated on 19 January 2010 at the Chelsea campus (1 day) Syllabus: Image theory, processing and perception A 1 day course module on the underpinning theory of medical imaging, including the mathematics of formation, image processing and human visual perception. Much of the material in this course is generally applicable to all types of imaging system. Illustrations and examples from medical imaging will be used throughout including ultrasound, nuclear medicine, MRI and x-ray CT. Mathematics of Medical Imaging Lecturer: Dr Mike Partridge Image formation – representation of images, convolution and Fourier theory. Describing imaging systems – linear systems, point spread function and transfer functions. Sampling theory – finite apertures and the sinc function. Nyquist rate and Whittaker-Shannon theory. Sampling artefacts, aliasing pre- and post-sample blurring. Noise – fixed pattern noise, Poisson noise, Johnson noise and nonlinearity. Introduction to image enhancement and filtering – point operators, spatial operators and transform operators. Image Processing Techniques Lecturer: Dr John Suckling Introduction and definitions – image sources, formats and colour representation and notation. Simple image processing techniques – contrast stretching, thresholding & pseudocolour, histogram equalisation and spatial filtering. Image analysis – fractal dimension, edge detection, object moments, erode and dilate. Linear scale space – irreducible and composite invariants Image classification – supervised and Bayesian classifiers, neural networks, unsupervised classifiers Image registration – cost functions, optimisation and interpolation. Perception and Interpretation of Medical Images Lecturer: to be confirmed The abilities and limitations of the human vision.
  3. 3. Contrast discrimination, spatial discrimination and image noise. Image display systems – controls and gamma characteristics. Experimental methods of assessing man & machine performance – ROC analysis, contrast detail tests etc. Three-Dimensional Image Display Lecturer: Prof Steve Webb Methodology of 3D display. From contours to wire frames and shaded surfaces. CT and SPECT data in 3D. Draft Timetable for Image theory, processing and perception 09:00 – 09:30 Registration 09:30 – 10:15 Mathematics of image formation I Dr Mike Partridge 10:15 – 11:00 Mathematics of image formation II Dr Mike Partridge 11:00 – 11:30 Coffee 11:30 – 12:15 Image processing techniques I Dr John Suckling 12:15 – 13:00 Image processing techniques II Dr John Suckling 13:00 – 14:00 Lunch 14:00 – 14:45 Perception and interpretation of medical images To be confirmed 14:45 – 15:30 Mathematics of image formation III Dr Mike Partridge 15:30 – 16:00 Tea 16:00 - 16:45 Three-dimensional image display Prof Steve Webb Module 3 – Ultrasound Imaging 25-27 November 2009 Sutton Campus of the Royal Marsden Hospital and Institute of Cancer Research Syllabus • Physics principles of ultrasound propogation, contrast agents, accoustic diffraction fields, echographic imaging and Doppler • Engineering principles of transducers, echographic imaging, Doppler velocimetry and Doppler imaging
  4. 4. • Ultrasound Bioeffects and safety • Quality and safety assurance for diagnostic ultrasound devices • Fields of application and research in medical ultrasound iimaging • Practical demonstrations and “hands-on” (numbers permitting) learning session • Visit to Ultrasound research laboratories Faculty Dr J Bamber Senior Lecturer, Institute of Cancer Research Dr J Fromageau Clinical Physicist, Royal Marsden NHS Foundation Trust Dr I Rivens Lecturer, Institute of Cancer Research Module 4 – Diagnostic Radiology and CT Ultrasound Imaging 20-22 January 2010 Chelsea Campus of The Royal Marsden Hospital Syllabus (provisional): Day 1: Diagnostic Radiology (analogue) 1. Introduction to Diagnostic Radiology I Lecturer: Lynn Martinez Trends in X-ray imaging in the United Kingdom. Projected and tomographic images. Components of the diagnostic radiological imaging system. Formation of the image. 2. Introduction to Diagnostic Radiology II Lecturer: Lynn Martinez Some aspects of the interaction of photons with tissue and image receptors at diagnostic energies. Important physical parameters: dose, contrast, unsharpness and noise. 3. Quantitative measures of the performance of image receptors Lecturer: Dimitra Darambara Definition and use of the modulation transfer function, noise power spectra, detective quantum efficiency and noise equivalent quanta in X-ray imaging. 4. X-ray tubes and generators
  5. 5. Lecturer: Slavik Tabakov The X-ray spectrum. Construction of the X-ray tube. Physical factors which affect the choice of filament, target and filter. Heel effect. Filament and high voltage circuits. Three phase and medium frequency generators. Automatic exposure control-principles of operation. Principles and applications of linear tomography. 5. Scatter rejection Lecturer: David Dance Scatter rejection: magnitude of scatter, scatter limitation. Grid design and use. Air gaps. 6. Films and screens Lecturer: David Dance Film: Construction of the film. Formation of the image. Simple model for optical density. H and D curves. Sensitivity, resolution and granularity. Film- processing. Screen-film receptors: Construction and use of the screen. Rare earth screens. Sensitivity, resolution and noise. 7. Image receptors III Lecturer: Stephen Evans Image intensifiers: Construction of the image intensifier. Methods of recording and displaying the image. Sensitivity, resolution and noise power spectra. Selection and use of contrast media. 8. Analogue system design and optimisation in clinical practice Lecturer: Elly Castellano The optimisation process. Summary of image quality parameters. Examples in chest radiography, mammography, vascular imaging and paediatric imaging Day 2: Diagnostic Radiology (digital) 9. Digital Radiology I Lecturer: Ed McDonagh Requirements for digital systems. Stimulated luminescence systems: Physical principles and construction of the receptor. Image read out and display. Sensitivity, resolution and noise. 10. Digital Radiology II Lecturer: Dimitra Darambara Flat panel detectors. Digital fluoroscopic/fluorographic systems. System features and performance. Other digital image receptors and systems.
  6. 6. 11. Digital Radiology III Lecturer: Dimitra Darambara Applications of digital systems. Mammography and chest imaging. Performance of digital systems. 12. PACS Lecturer: Ed McDonagh Advantages and disadvantages of PACS. PACS architecture. Archives. Workstations and grayscale standard display function. DICOM standard, HL7 and IHE. 13. Measurement of image quality in digital systems Lecturer: Dimitra Darambara Measurement of the modulation transfer function, noise power spectra, and detective quantum efficiency in digital X-ray imaging. 14. Quality Control I Lecturer: Claire Skinner Quality definitions. Legislative basis. Life cycle of X-ray equipment. Quality control of the imaging chain: tubes and generators. 15. Quality Control II Lecturer: Claire Skinner Quality control of the imaging chain: tubes and generators (continued); automatic exposure control; conventional tomography; image intensifier TV systems; mammography equipment; digital radiography equipment. 16. Digital system design and optimisation in clinical practice Lecturer: Elly Castellano The optimisation process for digital systems. Examples in chest radiography, mammography and vascular imaging. 17. Demonstration of X-ray Imaging Equipment and QC Lecturer: Claire Skinner Demonstration of quality control equipment and techniques in the X-ray Department. 18. Demonstration of CT scanner and tomographic imaging Lecturer: Elly Castellano
  7. 7. Introduction to a clinical CT scanner and demonstration of tomographic imaging techniques in the CT Department. Day 3: CT 19. Principles of computed tomography Lecturer: Lynn Martinez Slices from x-ray projections. Geometries for acquisition of projections: 1st , 2nd , 3rd , 4th generation. Electron beam CT. Spiral CT and linear interpolation of projection data. 2D detector arrays, multiple data acquisition channels and linear interpolation techniques for 4-slice CT scanners. Cone beam limitations. 20. X-ray CT - reconstructions from projections Lecturer: Steve Webb Reconstruction by 2D Fourier method, convolution and backprojection reconstruction, design and performance of filters in CBP technique. 21. The modern diagnostic CT scanner. Lecturer: Lynn Martinez Scanner components: tube and generator, filtration, collimation, data acquisition system, couch and gantry, computers. Reconstruction algorithms. Imaging sequence. Image display. 22. Reconstruction techniques for multi-slice and cone beam CT* Lecturer: Gavin Poludniowski Introduction to 3D back projection. Tuy conditions. Exact reconstructions approaches. Approximate reconstruction approaches. 23. CT scanner performance and quality control Lecturer: Elly Castellano In plane and z-axis spatial resolution, contrast resolution, dose and noise. Image artefacts: partial volume, beam hardening, aliasing, motion and equipment-related. Image quality variations in axial mode, single-slice and multi-slice spiral mode. Quality control. 24. Advances in CT scanning* Lecturer: Elly Castellano Advanced scanning features. Recent clinical developments. PET/CT and SPECT/CT. Cone beam CT for radiotherapy.
  8. 8. *not part of MSc syllabus Module 5 – Nuclear Medicine 16-18 February 2010 Sutton Campus of the Royal Marsden Hospital and Institute of Cancer Syllabus: • Introduction and Overview of Radioisotope Imaging • Radionuclide Production • Radiation Detectors • Radiation Protection in Nuclear Medicine • Radiopharmaceuticals I & II • The Gamma Camera and other Imaging Equipment • Quality Control and Performance Assessment of Gamma Camera Systems • Static and Dynamic Scintigraphy • Single Photon Emission Computed Tomography I & II • Clinical Applications of Nuclear Medicine /PET • Positron Emission Tomography I, II & III • Quantitative Imaging • Applications of Nuclear Medicine Imaging to Radionuclide Therapy I & II • Visit to Nuclear Medicine and PET Department Faculty: Dr S Buckley Radiotherapy Physicist, ABM University NHS Trust, Swansea Mrs B Cronin Service Lead – Nuclear Medicine & PET, The Royal Marsden NHS Foundation Trust Dr A Divoli Senior Physicist, The Royal Marsden NHS Foundation Trust Mr Jim Thurston Radiation Protection Supervisor, The Royal Marsden NHS Foundation Trust Dr M Guy Head of Nuclear Medicine Physics, Medway Maritime Hospital, Gillingham, Kent Dr A Hall (Head of Radiopharmacy), Consultant Clinical Scientist, The Royal Marsden NHS Foundation Trust Dr Cecilia Hindorf Physicist, Ecole Nationale Vétérinaire de Nantes, Nantes, France Professor V R McCready
  9. 9. Emeritus Professor of Nuclear Medicine, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research Dr S Sassi Head of PET Physics, The Royal Marsden NHS Foundation Trust Ms M Holstensson The Institute of Cancer Research Yassine Bouchareb Clinical Research Scientist, The Royal Marsden NHS Foundation Trust
  10. 10. Emeritus Professor of Nuclear Medicine, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research Dr S Sassi Head of PET Physics, The Royal Marsden NHS Foundation Trust Ms M Holstensson The Institute of Cancer Research Yassine Bouchareb Clinical Research Scientist, The Royal Marsden NHS Foundation Trust