Medical

physics
Introduction
Medical physics (also called biomedical physics, medical biophysics or applied
physics in medicine) is, generally speaking, the application of physics concepts,
theories and methods to medicine or healthcare. Medical physics departments may
be found in hospitals or universities.
In the case of hospital work, the term 'Medical Physicist' is the title of a specific
healthcare profession with a specific mission statement .Such Medical Physicists are
often found in the following healthcare specialties: diagnostic and intervention
radiology (also known as medical imaging), nuclear medicine, and radiation oncology
(also known as radiotherapy).

Mission statement of Medical

Physicists
"Medical Physicists will contribute to maintaining and improving the quality, safety and costeffectiveness of healthcare services through patient-oriented activities requiring expert
action, involvement or advice regarding the specification, selection, acceptance testing,
commissioning, quality assurance/control and optimised clinical use of medical devices and
regarding patient risks and protection from associated physical agents (e.g., x-rays,
electromagnetic fields, laser light, radionuclides) including the prevention of unintended or
accidental exposures; all activities will be based on current best evidence or own scientific
research when the available evidence is not sufficient. The scope includes risks to

volunteers in biomedical research, carers and comforters. The scope often includes risks to
workers and public particularly when these impact patient risk"
The term "physical agents" refers to ionising and non-ionising electromagnetic radiations,
static electric and magnetic fields, ultrasound, laser light and any other Physical Agent
associated with medical e.g., x-rays in computerised tomography (CT), gamma
rays/radionuclides in nuclear medicine, magnetic fields and radio-frequencies in magnetic
resonance imaging (MRI), ultrasound in ultrasound imaging and Doppler measurements
etc.

Areas of speciality
The International Organization for Medical Physics (IOMP) - the world's premier
professional organization for medical physics with nearly 22,000 members in 84 countries recognizes main areas of medical physics employment and focus. [9] These are:

Medical imaging physics

Medical imaging physics is also known as diagnostic and interventional radiology physics.
Clinical (both "in-house" and "consulting") physicists [10] typically deal with areas of testing,
optimization, and quality assurance of diagnostic radiology physics areas such as
radiographic X-rays, fluoroscopy, mammography, angiography, and computed tomography,
as well as non-ionizing radiation modalities such as ultrasound, and MRI. They may also be
engaged with radiation protection issues such as radiation exposure monitoring and
dosimetry. In addition, many imaging physicists are often also involved with nuclear
medicine systems, including single photon emission computed tomography (SPECT)
and positron emission tomography (PET). Sometimes, imaging physicists may be engaged
in clinical areas, but for research and teaching purposes, [11] such as e.g.
quantifying intravascular ultrasound as a possible method of imaging a particular vascular
object.

Radiation therapeutic physics

Radiation therapeutic physics is also known as radiotherapy physics or radiation oncology
physics. The majority of medical physicists currently working in the US, Canada, and some
western countries are of this group. A Radiation Therapy physicist typically deals with linear

accelerator (Linac) systems and kilovoltage x-ray treatment units on a daily basis, as well as
more advanced modalities such asTomoTherapy, gamma knife, cyberknife, proton therapy,
and brachytherapy.[12][13][14] The academic and research side of therapeutic physics may
encompass fields such as boron neutron capture therapy, sealed source
radiotherapy, terahertz radiation, high-intensity
focused ultrasound (including lithotripsy),optical radiation lasers, ultraviolet etc.
including photodynamic therapy, as well as nuclear medicine including unsealed source
radiotherapy, and photomedicine, which is the use of light to treat and diagnose disease.

Nuclear medicine physics

This is a branch of medicine that uses radiation to provide information about the functioning
of a person's specific organs or to treat disease. In most cases, the information is used by
physicians to make a quick, accurate diagnosis of the patient's illness. The thyroid, bones,
heart, liver and many other organs can be easily imaged, and disorders in their function
revealed. In some cases radiation can be used to treat diseased organs, or tumours. Five
Nobel Laureates have been intimately involved with the use of radioactive tracers in
medicine. Over 10,000 hospitals worldwide use radioisotopes in medicine, and about 90%
of the procedures are for diagnosis. The most common radioisotope used in diagnosis is
technetium-99, with some 30 million procedures per year, accounting for 80% of all nuclear
medicine procedures worldwide. In developed countries (26% of world population) the
frequency of diagnostic nuclear medicine is 1.9% per year, and the frequency of therapy
with radioisotopes is about one tenth of this.

Clinical audiology physics

Physics and acoustics for audiology: the basic physics of sound, instrumentation,
and the principles of digital signal processing involved in audiological research. Topics
include the physics of sound waves, room acoustics, the measurement of reverberation
time; the nature of acoustic impedance; the nature of filters and amplifiers, acoustics of
speech, calibration.

Laser medicine
Laser medicine consists in the use of lasers in medical diagnosis, treatments, or therapies, such
as laser photodynamic therapy

Medical optics
Medical optical imaging describes various imaging techniques using visible, ultraviolet,
and infrared light used in imaging. Examples of optical imaging in medicine are optical
coherence tomography, spectroscopy and Fluorescence microscope. Optical techniques
are widely used in ophthalmology for the detection of eye disease and for cancer detection
(e.g., Fluorescence guided surgery).
Because light is an electromagnetic wave, similar phenomena occur in X-rays, microwaves,
radio waves.

Devices
used in
medical
science
..

1-Electrocardiography
. Electrocardiography (ECG or EKG*) is the process of recording the electrical activity

of the heart over a period of time usingelectrodes placed on the skin. These electrodes
detect the tiny electrical changes on the skin that arise from the heart
muscle'selectrophysiologic pattern of depolarizing during each heartbeat. It is a very
commonly performed cardiology test.
In a conventional 12-lead ECG, 10 electrodes are placed on the patient's limbs and on
the surface of the chest. The overall magnitude of the heart's electrical potential is then
measured from 12 different angles ("leads") and is recorded over a period of time
(usually 10 seconds). In this way, the overall magnitude and direction of the heart's
electrical depolarization is captured at each moment throughout the cardiac cycle. [1] The
graph of voltage versus time produced by this noninvasive medical procedure is
referred to as an electrocardiogram.

Electrocardiography

ECG of a heart in normal sinus rhythm.

During each heartbeat, a healthy heart has an orderly progression of depolarization that
starts with pacemaker cells in thesinoatrial node, spreads out through the atrium,
passes through the atrioventricular node down into the bundle of His and into
thePurkinje fibers, spreading down and to the left throughout the ventricles. This orderly
pattern of depolarization gives rise to the characteristic ECG tracing. To the trained
clinician, an ECG conveys a large amount of information about the structure of the heart

and the function of its electrical conduction system. [2] Among other things, an ECG can
be used to measure the rate and rhythm of heartbeats, the size and position of the heart
chambers, the presence of any damage to the heart's muscle cells or conduction
system, the effects of cardiac drugs, and the function of implanted pacemakers.

2-Endoscope
An endoscope is an illuminated optical, typically slender and tubular instrument used to
look deep into the body and used in procedures called an endoscopy. "Endo" is Greek
for "within" while "scope" comes from the Greek word "skopos" meaning to target or
look out. It is used to examine the internal organs like the throat or esophagus.
Specialized instruments are named after their target organ. Examples
includes cystoscope (bladder), nephroscope (kidney), bronchoscope
(bronchus), arthroscope (joints) and colonoscope (colon).[1] It can be used to examine
visually and diagnose, or assist in surgery such as an arthroscopy

A flexible endoscope

Drawings of Bozzini's "Lichtleiter", an early endoscope

3-Medical ventilator

The Bird VIP Infant ventilator

A medical ventilator (or simply ventilator in context) is a mechanical ventilator, a
machine designed to move breathable air into and out of the lungs, to provide breathing
for a patient who is physically unable to breathe, or breathing insufficiently.
While modern ventilators are computerized machines, patients can be ventilated with a
simple, hand-operated bag valve mask.
Ventilators are chiefly used in intensive care medicine, home care, and emergency
medicine (as standalone units) and in anesthesia (as a component of an anesthesia
machine).
Medical ventilators are sometimes colloquially called "respirators," a term which stems
from commonly used devices in the 1950s (particularly the "Bird Respirator"). However,
in modern hospital and medical terminology, these machines are never referred to as
respirators, and use of "respirator" in this context is now a deprecated anachronism
which signals technical unfamiliarity.

Function
In its simplest form, a modern positive pressure ventilator consists of an
compressible air reservoir or turbine, air and oxygen supplies, a set of valves and tubes,
and a disposable or reusable "patient circuit". The air reservoir is pneumatically compressed
several times a minute to deliver room-air, or in most cases, an air/oxygen mixture to the
patient. If a turbine is used, the turbine pushes air through the ventilator, with a flow valve
adjusting pressure to meet patient-specific parameters..
Ventilators may also be equipped with monitoring and alarm systems for patient-related
parameters (e.g. pressure, volume, and flow) and ventilator function (e.g. air leakage, power

failure, mechanical failure), backup batteries, oxygen tanks, and remote control. The
pneumatic system is nowadays often replaced by a computer-controlled turbopump.

4-CT scan
.

A CT scan makes use of computer-processed combinations of many X-ray images

taken from different angles to produce cross-sectional (tomographic) images (virtual
"slices") of specific areas of a scanned object, allowing the user to see inside the object
without cutting.
Digital geometry processing is used to generate a three-dimensional image of the inside
of the object from a large series of two-dimensional radiographic images taken around a
single axis of rotation.[2] Medical imaging is the most common application of X-ray CT.
Its cross-sectional images are used for diagnostic and therapeutic purposes in various
medical disciplines.[3] The rest of this article discusses medical-imaging X-ray CT;
industrial applications of X-ray CT are discussed at industrial computed tomography
scanning.
The term computed tomography (CT) is often used to refer to X-ray CT, because it is the
most commonly known form. But, many other types of CT exist, such as positron
emission tomography (PET) and single-photon emission computed
tomography(SPECT). Older and less preferred terms that also refer to X-ray CT are
computed axial tomography (CAT scan) and computer aided tomography. X-ray
Tomography is one form of radiography, along with many other forms of tomographic
and non-tomographic radiography.

CT scan
Intervention

Modern CT scanner

5Electroencephalography
Electroencephalography (EEG) is an electrophysiological monitoring method to record electrical
activity of the brain. It is typically noninvasive, with the electrodes placed along the scalp, although
invasive electrodes are sometimes used in specific applications. EEG measures voltage fluctuations
resulting from ionic current within the neurons of the brain.[1] In clinical contexts, EEG refers to the
recording of the brain's spontaneous electrical activity over a period of time, [1] as recorded from
multipleelectrodes placed on the scalp. Diagnostic applications generally focus on the spectral
content of EEG, that is, the type of neural oscillations (popularly called "brain waves") that can be
observed in EEG signals.
EEG is most often used to diagnose epilepsy, which causes abnormalities in EEG readings.[2] It is
also used to diagnose sleep disorders, coma, encephalopathies, and brain death. EEG used to be a
first-line method of
diagnosis
for tumors, stroke a
nd other focal brain
Electroencephalography
disorders,
Intervention

Epileptic spike and wave discharges monitored

with EEG

Medical use
A routine clinical EEG recording typically lasts 2030 minutes (plus preparation time) and
usually involves recording from scalp electrodes. Routine EEG is typically used in the
following clinical circumstances:

to distinguish epileptic seizures from other types of spells, such as psychogenic nonepileptic seizures, syncope (fainting), sub-corticalmovement
disorders and migraine variants.

to differentiate "organic" encephalopathy or delirium from primary psychiatric

syndromes such as catatonia

to serve as an adjunct test of brain death

to prognosticate, in certain instances, in patients with coma

to determine whether to wean anti-epileptic medications

Positron Emission Tomography

Intervention

6Image of a typical positron emission tomography (PET)

facility

Positron emission
tomography
Positron emission tomography (PET)[1] is a nuclear medicine, functional
imaging technique that is used to observe metabolic processes in the body. The system
detects pairs of gamma rays emitted indirectly by a positronemitting radionuclide (tracer), which is introduced into the body on a biologically active
molecule. Three-dimensional images of tracer concentration within the body are then
constructed by computer analysis. In modern PET-CT scanners, three dimensional
imaging is often accomplished with the aid of a CT X-ray scan performed on the patient
during the same session, in the same machine.

Uses
PET is both a medical and research tool. It is used heavily in clinical oncology (medical
imaging of tumors and the search for metastases), and for clinical diagnosis of certain
diffuse brain diseases such as those causing various types of dementias. PET is also an
important research tool to map normal human brain and heart function, and support drug
development.

7-Magnetic resonance
imaging
Magnetic resonance imaging (MRI) is a medical imaging technique used
in radiology to form pictures of the anatomy and the physiological processes of the body
in both health and disease. MRI scanners use strong magnetic fields, radio waves,
and field gradients to generate images of the inside of the body.
MRI is based upon the science of nuclear magnetic resonance (NMR). Certain atomic
nuclei can absorb and emit radio frequencyenergy when placed in an external magnetic
field. In clinical and research MRI, hydrogen atoms are most-often used to generate a
detectable radio-frequency signal that is received by antennas in close proximity to the
anatomy being examined. Hydrogen atoms exist naturally in people and other biological
organisms in abundance, particularly in water and fat. For this reason, most MRI scans

essentially map the location of water and fat in the body. Pulses of radio waves excite
the nuclear spin energy transition, and magnetic field gradients localize the signal in
space. By varying the parameters of the pulse sequence, different contrasts can be
generated between tissues based on the relaxation properties of the hydrogen atoms
therein.

Medical uses[edit]
MRI has a wide range of applications in medical diagnosis and over 25,000 scanners are
estimated to be in use worldwide.[1] MRI affects diagnosis and treatment in many specialties
although the effect on improved health outcomes is uncertain. [2] Since MRI does not use any
ionizing radiation, its use is generally favored in preference to CT when either modality
could yield the same information.[3] (In certain cases, MRI is not preferred as it can be more
expensive, time-consuming, and claustrophobia-exacerbating).
MRI is in general a safe technique but the number of incidents causing patient harm has
risen.[citation needed] Contraindications to MRI include most cochlear implants and cardiac
pacemakers, shrapnel and metallic foreign bodies in the eyes. The safety of MRI during the
first trimester of pregnancy is uncertain, but it may be preferable to other options. [4]The
sustained increase in demand for MRI within the healthcare industry has led to concerns
about cost effectiveness and overdiagnosis.

8-Medical ultrasound
Medical ultrasound (also known as diagnostic sonography or ultrasonography) is
a diagnostic imaging technique based on the application of ultrasound. It is used to see
internal body structures such as tendons, muscles, joints, vessels and internal organs. Its
aim is often to find a source of a disease or to exclude any pathology. The practice of
examining pregnant women using ultrasound is called obstetric ultrasound, and is widely
used.

Ultrasound is sound waves with frequencies which are higher than those audible to humans
(>20,000 Hz). Ultrasonic images also known as sonograms are made by sending pulses of
ultrasound into tissue using a probe. The sound echoes off the tissue; with different tissues
reflecting varying degrees of sound. These echoes are recorded and displayed as an image
to the operator.
Many different types of images can be formed using sonographic instruments. The most
well-known type is a B-mode image, which displays the acoustic impedance of a twodimensional cross-section of tissue. Other types of image can display blood flow, motion of
tissue over time, the location of blood, the presence of specific molecules, the stiffness of
tissue, or the anatomy of a three-dimensional region.

Medical ultrasonography
Intervention

Sonographer doing pediatric echocardiography

9-X-ray
X-radiation (composed of X-rays) is a form ofelectromagnetic radiation. Most X-rays have
awavelength ranging from 0.01 to 10nanometers, corresponding to frequencies in the range
30 petahertz to 30 exahertz (31016Hz to 31019 Hz) and energies in the range 100 eV to

100 keV. X-ray wavelengths are shorter than those of UV rays and typically longer than
those of gamma rays. In many languages, X-radiation is referred to with terms
meaning Rntgen radiation, after Wilhelm Rntgen,[1] who is usually credited as its
discoverer, and who had named it X-radiationto signify an unknown type of radiation.
Spelling of X-ray(s) in the English language includes the variants x-ray(s), xray(s), and X

[2]

ray(s).[3]
X-rays with high photon energies (above 510 keV, below 0.20.1 nm wavelength) are
called hard X-rays, while those with lower energy are called soft X-rays.[4] Due to their
penetrating ability, hard X-rays are widely used to image the inside of objects, e.g.,
in medical radiography and airport security. The term X-ray is metonymically used to refer to
a radiographic image produced using this method, in addition to the method itself. Since the
wavelengths of hard X-rays are similar to the size of atoms they are also useful for
determining crystal structures by X-ray crystallography. By contrast, soft X-rays are easily
absorbed in air; the attenuation length of 600 eV (~2 nm) X-rays in water is less than 1
micrometer.[5]

X-rays are part of the electromagnetic spectrum, with wavelengths shorter than visible light. Different
applications use different parts of the X-ray spectrum.

10-Fluroscope
machine and
Fluoroscopy
Fluoroscopy (/flrskpi, flr-/[1]) is an imaging technique that uses X-rays to obtain realtime moving images of the interior of an object. In its primary application of medical imaging,
a fluoroscope (/flrskop,flr-/[2][3]) allows a physician to see the
internal structure and function of a patient, so that the pumping action of the heart or the
motion of swallowing, for example, can be watched. This is useful for
both diagnosis and therapyand occurs in general radiology, interventional radiology, and
image-guidedsurgery. In its simplest form, a fluoroscope consists of an X-ray source and
a fluorescent screen, between which a patient is placed. However, since the 1950s most
fluoroscopes have included X-ray image intensifiers andcameras as well, to improve the
image's visibility and make it available on a remote display screen. For many decades
fluoroscopy tended to produce live pictures that were not recorded, but since the 1960s, as
technology improved, recording and playback became the norm.
Fluoroscopy is similar to radiography and X-ray computed tomography (X-ray CT) in that it
generates images using X-rays. The original difference was that radiography fixed still
images on film whereas fluoroscopy provided live moving pictures that were not stored.

Fluoroscopy
CT,

Intervention

However, today radiography,

and fluoroscopy are all digital
imaging modes with image
analysis software and data
storage and retrieval.