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3. Module Outline: Imaging Basics Highlight key events in the historical development of imaging Identify techniques used in modern imaging departments Review which techniques do or do not use ionizing radiation Explain radiological orientations, directions & conventions This module will …

4. Module Author: Imaging Basics Andrew Farrall Dr Farrall came to the Division of Clinical Neurosciences in 2002 from Canada, where he trained as a Radiologist in Halifax, Nova Scotia. He obtained an MD in 1997 from the University of Calgary in Alberta, an MSc in 1995 from the University of Western Ontario in London, Ontario, and a BSc (Hons) from the University of British Columbia in Vancouver in 1990. He has part time appointments as a Fellow at the University of Edinburgh and as a Consultant Neuroradiologist in the NHS, with sessions at the Western General Hospital & at St. John's Hospital. His main interests are in Stroke Neuroradiology & the role of Magnetic Resonance in its investigation. Lacunar stroke, dementias & small vessel disease form the core of his research. He is also interested in teaching issues in Neuroradiology.

5. The slides that follow are those used for the final presentation

7. Module:Techniques & Physics Lecture:Imaging Basics Description:History, terminology & orientation Author:Dr. Andrew Farrall

8. Highlight key events in the historical development of imaging Identify techniques used in modern imaging departments Review which techniques do or do not use ionizing radiation Explain radiological orientations, directions & conventions Objectives:

9. There are no pre-requisites for this session Prerequisites:

10. Brief Historical Outline X-rays were discovered by Wilhelm Conrad Röntgen in 1895 which is generally accepted as being the birth of radiology. Since that time, X-ray radiology technology has taken advantage of technological advancements in image capture & representation, and also has evolved with computing advances. Also, other techniques for imaging have been developed, some using radiation and others not. What follows is a timeline summary of some key events in the history of imaging.

11. Imaging Orientation & Direction “Superior” refers to anything above your point of reference, where above means in a direction towards the top of the head e.g. the nose is superior to the lips “Inferior” refers to anything below your point of reference, where below means in a direction towards the feet e.g. the lips are inferior to the nose. Superiorly Inferiorly

12. Image Conventions By convention, when we view images, we look at them as though we are actually looking at the patient “face-to-face”. Therefore, the RIGHT side of a radiological image as you look at it is the patient’s LEFT side; the LEFT side of a radiological image is the patient’s RIGHT side. Often a marker “R” or “L” embedded in the film indicates which is the patient’s right or left. Patient’s right side Patient’s left side Skull X-ray Superior Inferior

13. Modern Imaging Departments Imaging techniques used in modern imaging departments can be divided into those which use ionizing radiation and those which do not. RadiationNo Radiation

14. Modern Imaging Departments Two commonly used techniques which do not use ionizing radiation to create images are Magnetic Resonance Imaging (MRI) and Ultrasound (US). No Radiation Ultrasound Magnetic Resonance Imaging Radiation

15. Imaging Orientation & Direction “Lateral” refers to anything lying towards the sides, left or right, relative to your point of reference “Medial” refers to anything lying towards a plane running through the middle of the body, dividing it into left and right halves e.g. the nose lies medially to the eyes. Laterally rightLaterally leftMedial

16. Summary Outline the historical development of imaging Identify techniques used in modern imaging departments Identify which techniques do or do not use ionizing radiation Distinguish between techniques which use ionizing radiation Understand radiological orientations, directions & convention You should now be able to:

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19. Module Resources: Imaging Basics Books o Huda W, Stone R, Review of radiologic physics. Williams & Wilkins, Media, PA, 1995.

20. Learning Activities: Imaging Basics Question (Matching): (1) Match the correct date with the corresponding event: First magnetic resonance image published 1946 Functional magnetic resonance imaging becomes feasible 1973 First successful magnetic resonance experiment 1977 First human magnetic resonance image obtained 1991

21. Learning Activities: Imaging Basics Answer: (1) Match the correct date with the corresponding event: First magnetic resonance image published 1946 Functional magnetic resonance imaging becomes feasible 1973 First successful magnetic resonance experiment 1977 First human magnetic resonance image obtained 1991

22. Learning Activities: Imaging Basics Question (Ranking): (2) Put the following events into the correct order: First successful (NMR) experiment Radioactivity discovered X-rays discovered Scintillation camera developed Ultrasound in clinical practice starts

23. Learning Activities: Imaging Basics Answer: (2) Put the following events into the correct order: First successful (NMR) experiment3 Radioactivity discovered2 X-rays discovered1 Scintillation camera developed5 Ultrasound in clinical practice starts4

24. Learning Activities: Imaging Basics Question (Matrix): (3) Match the person with the underlying imaging principle: Edward Purcell X-raysRadioactivityMRUltrasound Antoine-Henri Becquerel X-raysRadioactivityMRUltrasound Ernest Lawrence X-raysRadioactivityMRUltrasound Godfrey Hounsfield X-raysRadioactivityMRUltrasound Paul Lauterbur X-raysRadioactivityMRUltrasound Felix Bloch X-raysRadioactivityMRUltrasound Wilhelm Conrad Röntgen X-raysRadioactivityMRUltrasound

25. Learning Activities: Imaging Basics Answers: (3) Match the person with the underlying imaging principle: Edward Purcell X-raysRadioactivityMRUltrasound Antoine-Henri Becquerel X-raysRadioactivityMRUltrasound Ernest Lawrence X-raysRadioactivityMRUltrasound Godfrey Hounsfield X-raysRadioactivityMRUltrasound Paul Lauterbur X-raysRadioactivityMRUltrasound Felix Bloch X-raysRadioactivityMRUltrasound Wilhelm Conrad Röntgen X-raysRadioactivityMRUltrasound

26. Learning Activities: Imaging Basics Question (Multiple response): (4) Mark all imaging techniques which rely on ionizing radiation to create images: PET Ultrasound CT MRI SPECT

27. Learning Activities: Imaging Basics Answer: (4) Mark all imaging techniques which rely on ionizing radiation to create images: PET Ultrasound CT MRI SPECT

28. Learning Activities: Imaging Basics Question (Multiple response): (5) Mark all imaging techniques which rely on injection of radiating isotopes to create images: Ultrasound CT SPECT PET MRI

29. Learning Activities: Imaging Basics Answer: (5) Mark all imaging techniques which rely on injection of radiating isotopes to create images: Ultrasound CT SPECT PET MRI

30. Learning Activities: Imaging Basics Question (True/False): (6) With reference to the image of the head: a bc d e “a” lies laterally to the nearest eye “b” lies medially to both eyes “b” lies superiorly to the mouth “d” lies superiorly to the mouth “e” lies inferiorly to the nose

31. Learning Activities: Imaging Basics Answer: (6) With reference to the image of the head: a bc d e “a” lies laterally to the nearest eyeTrue “b” lies medially to both eyesTrue “b” lies superiorly to the mouthTrue “d” lies superiorly to the mouthTrue “e” lies inferiorly to the noseTrue

32. Learning Activities: Imaging Basics Question (True/False): (7) With reference to the image of the head: a b c d e “a” lies posteriorly to the ear “b” lies superiorly to the ear “c” lies anteriorly to the ear “c” lies inferiorly to the eye “c” lies posteriorly to the nose

33. Learning Activities: Imaging Basics Answer: (7) With reference to the image of the head: a b c d e “a” lies posteriorly to the earTrue “b” lies superiorly to the earTrue “c” lies anteriorly to the earTrue “c” lies inferiorly to the eyeTrue “c” lies posteriorly to the noseTrue

34. Learning Activities: Imaging Basics Question (Drag & drop): (8) Place the labels adjacent to the appropriate images: Upright or erect Prone Supine Ground or Floor

35. Learning Activities: Imaging Basics Answer: (8) Place the labels adjacent to the appropriate images: Ground or Floor Prone Upright or erect Supine

36. Learning Activities: Imaging Basics Question (Drag & drop): (9) Place any applicable labels for this conventionally displayed frontal skull X-ray in the appropriate locations: Inferior Left Right Superior Posterior Anterior

37. Learning Activities: Imaging Basics Answer: (9) Place any applicable labels for this conventionally displayed frontal skull X-ray in the appropriate locations: Inferior LeftRight Superior Posterior Anterior

38. Learning Activities: Imaging Basics Question (Drag & drop): (10) Place any applicable labels for this conventionally displayed axial head CT image in the appropriate locations: Inferior Left Right Superior Posterior Anterior

39. Learning Activities: Imaging Basics Answer: (10) Place any applicable labels for this conventionally displayed axial head CT image in the appropriate locations: Inferior LeftRight Superior Posterior Anterior

40. Learning Activities: Imaging Basics Question (Fill in the blank): (11) Using conventional imaging terminology, the projection of the skull X-ray illustrated below is: ________________

41. Learning Activities: Imaging Basics Answer: (11) Using conventional imaging terminology, the projection of the skull X-ray illustrated below is: lateral

42. Learning Activities: Imaging Basics Question (Matrix): (12) Select the orientation of the section defined by the orange plane: AxialCoronalSagittal AxialCoronalSagittal AxialCoronalSagittal AxialCoronalSagittal

43. Learning Activities: Imaging Basics Answer: (12) Select the orientation of the section defined by the orange plane: AxialCoronalSagittal AxialCoronalSagittal AxialCoronalSagittal AxialCoronalSagittal