MEDICAL IMAGING COURSE SYLLABUS Module 1 Magnetic Resonance Imaging and Spectroscopy 31 Oct-2 November 2011 Sutton Campus

s 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 Guys and St Thomass 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

Module 2 Ultrasound Imaging 23-25 November 2011 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 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 3 Image Theory, perception and processing 24 January 2012 (1 day) Chelsea Campus of the Royal Marsden Hospital and Institute of Cancer Research 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: Dr E Harris The abilities and limitations of the human vision. 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: To be confirmed 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 09:30 10:15 10:15 11:00 11:00 11:30 11:30 12:15 12:15 13:00 13:00 14:00 14:00 14:45 14:45 15:30 15:30 16:00 16:00 - 16:45 Registration Mathematics of image formation I Dr Mike Partridge Mathematics of image formation II Dr Mike Partridge Coffee Image processing techniques I Dr John Suckling Image processing techniques II Dr John Suckling Lunch Perception and interpretation of medical images Dr E Harris Mathematics of image formation III Dr Mike Partridge Tea Three-dimensional image display To be confirmed

Module 4 Diagnostic Radiology and CT Ultrasound Imaging 25-27 January 2012 Chelsea Campus of The Royal Marsden Hospital Syllabus (provisional): Day 1: Diagnostic Radiology (analogue) 1. Introduction to Diagnostic Radiology I Lecturer: Jim Thurston

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: Jim Thurston

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 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. Filmprocessing. Screen-film receptors: Construction and use of the screen. Rare earth screens. Sensitivity, resolution and noise. 7. Image intensifiers Lecturer: Laurence King

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.

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

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: To be confirmed

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. *not part of MSc syllabus Module 5 Nuclear Medicine 14-17 February 2012 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 Application of PET &SPECT in Radiotherapy Planning Radiopharmaceuticals The Gamma Camera and other Imaging Equipment Quality Control and Performance Assessment of Gamma Camera Systems Nuclear Medicine Imaging Techniques Photon Emission Computed Tomography Fundamentals Quantiative SPECT Clinical Applications of Nuclear Medicine /PET Introduction and the MIRD Scheme Quantitative Imaging Applications of internal dosimetry Treatment planning, radiobiology and future directions Clinical aspects of TRT PET Tracer production & development Molecular Targeting in PET PET Fundamentals Clinical aspects of PET/CT Quantification in PET Advances in PET Techynology Radionuclide Therapy Visit to Nuclear Medicine and PET Department

Faculty:
Dr M Bardies Dr G Cook Radionuclide Dosimetry Group, INSERM, Nantes, France Consultant, Nuclear Medicine, The Royal Marsden NHS Foundation Trust Consultant Nuclear Medicine Radiologist, The Royal Marsden NHS Foundation Trust

Dr S Chua

Ms B Cronin

Radioisotope Services Manager, Nuclear Medicine and PET/CT, The Royal Marsden NHS Foundation Trust Research Physicist, Institute of Cancer Research Senior Physicist, The Royal Marsden NHS Foundation Trust Head of Radioisotope Physics, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research Consultant Clinical Oncologist, University College Hospital London Radioisotopes, The Royal Marsden NHS Foundation Trust Head of Imaging and Nuclear Medicine Physics, Southampton General Hospital Consultant Clinical Scientist (Head of Radiopharmacy), The Royal Marsden NHS Foundation Trust Career Development Faculty, Institute of Cancer Research Head of Radiation Protection, Physics Department, The Royal Marsden NHS Foundation Trust Reader in Mathematical Neuroscience and Head of PETMethodology Group, MRC Clinical Sciences Centre, Hammersmith Hospital Imperial College

Dr D Darambara Dr A Divoli Dr G Flux

Dr M Gaze

Dr J Gear Dr M Guy

Dr A Hall Dr M Partridge Dr J Thurston

Dr F Turkheimer