University of Technology Sydney

91403 Medical Imaging

Warning: The information on this page is indicative. The subject outline for a particular session, location and mode of offering is the authoritative source of all information about the subject for that offering. Required texts, recommended texts and references in particular are likely to change. Students will be provided with a subject outline once they enrol in the subject.

Subject handbook information prior to 2021 is available in the Archives.

UTS: Science: Mathematical and Physical Sciences
Credit points: 6 cp
Result type: Grade and marks

Requisite(s): 68041 Physical Aspects of Nature OR 68101 Foundations of Physics OR 68037 Physical Modelling
These requisites may not apply to students in certain courses. See access conditions.
Anti-requisite(s): 68202 Medical Imaging Technology

Description

This subject provides fundamental principles regarding imaging modalities and a broad background, based on physics, to establish an understanding of how particular imaging techniques have been developed and their clinical and research applications. It covers an examination of the role and effectiveness of clinical imaging, an overview of generic characteristics, and a detailed examination of specific imaging modalities including x-rays, ultrasound, computed tomography, nuclear medicine and magnetic resonance imaging. The subject includes lectures, practicals and workshops.

Subject learning objectives (SLOs)

Upon successful completion of this subject students should be able to:

1. Describe and relate the clinical applications and limitations of each imaging quality
2. Identify and analyse the principal functional components of a medical imaging device
3. Critically evaluate radiographic and other types of medical images against criteria that determine the final quality of images
4. Relate the image quality on diagnostic impact and patient management
5. Critically evaluate medical imaging technologies from a safety perspective
6. Research, analyse and communicate technical information relating to medical imaging

Course intended learning outcomes (CILOs)

This subject also contributes specifically to the development of following course intended learning outcomes:

  • Analyse: Select and appraise the technology and tools to detect and diagnose diseases. (1.2)
  • Analyse: Examine and use appropriate scientific tools in the design and execution of medical science research. (2.2)
  • Synthesise: Work responsibly, safely, and with respect to diversity, within ethical, academic, and regulatory frameworks relevant to medical science. (3.3)
  • Synthesise: Work creatively to translate the results of medical research to improve the clinical care of patients and/or the mechanisms of disease. (4.3)
  • Apply: Communicate medical science effectively in a number of multimedia forms to a wide range of audiences. (5.1)
  • Analyse: Establish high-quality writing and oral skills to effectively communicate reports and other relevant ideas to a range of audiences. (5.2)

Contribution to the development of graduate attributes

1. Disciplinary knowledge

This subject will facilitate students to gain relevant disciplinary understanding of the nature, practice and application of medical imaging technology through lectures, computer practicals, workshops and presentations. The material will be assessed in the two tests (middle and at the end of semester).


2. Research, Enquiry and Critical Thinking
This subject will nurture the students' capacity for critical and analytical thinking and for creative problem solving through excercises at the practicals, workshops and in preparation for video presentations.


3. Professional, ethical and social responsibility
Time management, personal organization, teamwork and communication skills will be developed through the presentation projects and individual report writing.

4. Reflection, Innovation and Creativity

Innovative and creative thinking will be trained in group video presenation and report preparation tasks. Reflective thinking will be enhanced in solving quantitative problems and preparation for tests.

5. Communication
In this subject, students will be better equipped with written and verbal communication skills through discussion and layout of conclusions based on data and factual information. In preparation for Assessment task 3, resources and guidance will be provided on storyboarding strategy, as well as the visual and audio aspects of a digital presentation.

Teaching and learning strategies

The subject is delivered by lectures, workshops and computer practicals. Canvas will be used to disseminate all learning materials, to provide a forum for general and topic-based discussions, and to upload students’ work.

There will be weekly online lectures of two hours, delivered in a Zoom or pre-recorded webinar mode. Students must prepare prior to lectures to enhance understanding of the topics.

Workshops provide the framework for students to master quantitative aspects of the lecture material. There will be opportunities to work in groups and receive feedback from tutors and peers. The class will be divided into teams to solve the quantitative problems. The students can talk through their solutions prior to class discussions. Time is set aside in the workshop for guidance on the digital presentation task and for discussion of presentations.

In computer practicals, each student makes use of image processing software to explore important aspects of medical imaging: image quality and image registration. Students are encouraged to interact and share insights with each other during the computer practicals. There are two practicals, each involving a prelab activity. Prior to the first practical, each student acquires a specified image, which will then be used during the practical. A pre-reading material is provided prior to the second practical. Data generated from the computer practicals will be utilised to write two individual Practical Reports for online submission. Formative verbal and written feedback is provided across the entire semester.

A major activity in this subject revolves around the digital presentation task. Students work in a team to research a selected topic on Medical Imaging, work up a storyboard and create a digital presentation.

Content (topics)

The subject begins with an overview of medical imaging and an examination of its role in clinical diagnosis and non-diagnostic applications. The effectiveness of the technology is defined and its costs and benefits discussed. A historical overview illustrates the interplay between development of science and its applications. Image quality is defined and its intrinsic trade-offs discussed. A generic imaging system is introduced and its principal characteristics defined.

The introductory material serves to provide a frame of reference for material that follows, which deals with individual medical imaging modalities, their operation and applications. The material concludes with an overview of selected emerging techniques.

Specific Program

Medical imaging: its role and effectiveness
Diagnostic pathway and the role of imaging. Cost and safety. Effectiveness at the level of diagnosis and impact on patient morbidity/mortality. Optimal imaging pathways. Therapeutic and other applications. Historical introduction (from Roentgen to Lauterbur): serendipity or clinical demand? Australian perspective: the practice of medical imaging and the role of various players, equipment development, role of government in regulating the penetration of imaging technology.

Image quality
Image quality and principal parameters: contrast, resolution, signal-to-noise ratio. Contrast enhancement. Grey scale windowing. Pseudo-colour scales. Display of 3D image data.

Generic imaging system
Generic imaging system: radiation source, tissue property being imaged, radiation detector. Role of radiation as information carrier and as agent in eliciting the tissue properties. Implementations of imaging systems. Electromagnetic wave spectrum and the effect of wavelength on the interactions with tissues. The effect of wavelength in defining the source/detector equipment. Dimensionality of image data. Multiple properties. Time dependence, dynamic imaging. Relationship of the physical tissue property to the clinically desired properties. Distinction between anatomic and functional imaging.

Endoscopy
Principles and equipment: rod lenses in rigid endoscopes and total internal reflection in fiberoptic endoscopes. Light sources and detectors. Auxiliary apparatus. Applications: from colonoscopy to arthroscopy. Role in keyhole surgery. Comparison with virtual endoscopy.

X-ray imaging
X-ray imaging systems. Common elements. Production of x-rays. Interactions of x-rays with tissues. Detection of x-rays. Recording and display. Plain x-ray (projection) imaging and its clinical applications. Digital radiography, comparison with analog imaging. Fluoroscopy, digital subtraction angiography. Contrast media, their effectiveness and hazards.

X-ray CT
X-ray computed tomography. Its analogue antecedents and development from pencil-beam with single detector (first generation) to wide beam with detector ring (fourth generation) and electron beam systems. Multi-slice imaging. Spiral scanning. Acquisition of projections. Reconstruction from projections: simple backprojection, filtered backprojection, iterative algorithms. Display of image data. Clinical applications. Non-clinical examples (archaeology, paleontology, zoology).

Ultrasound imaging
Production and detection of ultrasound. Beam profile and lateral resolution. Focusing and steering. Interaction with tissues. Acoustic impedance. Assumption of velocity invariance. Image formation. Real-time constraints. Penetration and attenuation, time-gain compensation, frequency dependence. 3D-4D imaging. Surface rendering. Doppler imaging. Applications: musculo-skeletal, abdominal, obstetric/gynaecological, cardiac, vascular, small parts.

Nuclear medicine
Review of radioactivity: type of radiation, range, energy, half-life. Production of common isotopes: on-site Tc99m generator, cyclotron-produced positron emitters. Radiopharmaceuticals and their distributions in tissues. Gamma camera. Image display in plain scintigraphy. Image characteristics and clinical applications (bone scintigraphy, cardiac, lung, brain, gastro-intestinal). Single-photon emission computed tomography (SPECT) and positron emission tomography (PET). Equipment and applications. Use of implanted radioactive sources in cancer therapy.

MR imaging
Magnetic resonance imaging. From nuclear spins to an image. Nuclear magnetic spectroscopy. Historical overview. Principal elements of equipment. Radiofrequency pulses, gradients, precession. Tissue characteristics: spin density, longitudinal relaxation time (T1) and transverse relaxation time (T2). Spin-echo, inversion recovery, steady-state pulse sequences. Image reconstruction: frequency- and phase-encoding gradients. Standard Fourier imaging and trajectory in k-space. Rapid imaging: low flip angle, echo-planar and related methods. Image characteristics: resolution, chemical shift, dependence of in-vivo image contrast on intrinsic parameters and pulse sequence parameters. Contrast agents: paramagnetic elements. Safety of static, switched and oscillating fields. MR angiography (macroscopic proton motion), MR spectroscopy (distribution of chemical species), diffusion imaging (microscopic proton motion), fMR (functional MR imaging). Clinical applications from neurology to musculoskeletal system.

Assessment

Assessment task 1: Practical Reports

Intent:

This assessment task contributes to the development of the following graduate attributes:

1. Disciplinary knowledge.
2. Research, inquiry and critical thinking.
4. Reflection, innovation and creativity.
5. Communication.
Objective(s):

This assessment task addresses subject learning objective(s):

3, 4 and 6

This assessment task contributes to the development of course intended learning outcome(s):

1.2, 2.2, 4.3 and 5.2

Type: Report
Groupwork: Group, individually assessed
Weight: 25%
Criteria:

Each report contributes 12.5% to the total mark for the subject.

Assessment criteria comprise application of the scientific method, skills in data analysis, and scientific communication skills in presenting and discussing conclusions based on acquired data.

Assessment task 2: Test

Intent:

This assessment task contributes to the development of the following graduate attributes:

1. Disciplinary knowledge

2. Research, inquiry and critical thinking

3. Professional, ethical and social responsibility

4. Reflection, innovation and creativity
Objective(s):

This assessment task addresses subject learning objective(s):

1, 2, 3, 4 and 5

This assessment task contributes to the development of course intended learning outcome(s):

1.2, 2.2, 3.3 and 4.3

Type: Quiz/test
Groupwork: Individual
Weight: 50%
Criteria:

This assessment task will cover the topics presented in weeks 2-12 lectures & weeks 2-12 workshops. The test will comprise both qualitative and quantitative questions.

Assessment task 3: Digital Media Presentation

Intent:

This assessment task contributes to the development of the following graduate attributes:

1. Disciplinary Knowledge

2. Research, inquiry and critical thinking

3. Professional, ethical and social responsibility

4. Reflection, Innovation, Creativity

5. Communication
Objective(s):

This assessment task addresses subject learning objective(s):

1, 2, 3, 4, 5 and 6

This assessment task contributes to the development of course intended learning outcome(s):

1.2, 2.2, 3.3, 4.3 and 5.1

Type: Presentation
Groupwork: Group, group and individually assessed
Weight: 25%
Length:

Up to 10 minutes of digital media presentation
Criteria:

The assignment contributes 25% of the total assessment. The assignment will be marked according to the criteria detailed in the provided rubric. The criteria relate to the topic’s clear introduction and explanation, significance and applications, well-focused evaluation, clear conclusion, quality of presentation and the students’ good command of topic.

Minimum requirements

To pass the subject, you must achieve an overall mark of at least 50%.

Recommended texts

Several texts come close in ambit, currency and assumed knowledge to the material presented in this subject. They target radiology registrars preparing for the imaging physics examination and are comprehensive somewhat beyond the requirements of the subject. Of these,

  • Hendee, WR, and Ritenour, ER, Medical imaging physics. Wiley-Liss, 2003, on-line

is most readily accessible – electronic access is provided through the Library. Where appropriate, references will be made to chapters of this textbook.

Some topics (endoscopy, PET) are either absent or are treated cursorily in Hendee's text. The following on-line references attempt to fill the gaps:

  • Cotton, PB, Practical gastrointestinal endoscopy: the fundamentals, Blackwell 2003, (esp. Chap. 2), on-line
  • The SAGES manual, Fundamentals of laparoscopy, thoracoscopy, and GI endoscopy, Springer 2006, (esp. Chap. 47), on-line
  • Saha, GB, Basics of PET imaging physics, chemistry, and regulations, Springer 2010, on-line

Two texts that are largely equivalent to Hendee in content, level of presentation and currency, are:

  • Dowsett, DJ, Kenny, Pam and Johnston, RE, The physics of diagnostic imaging. Hodder Arnold 2nd ed. 2006.
  • Bushberg, JT, Seibert, JA, Leidholdt, EM Jr, and Boone, JM, The essential physics of medical imaging. Lipponcott Williams & Wilkins, 2nd ed. 2002.

Other useful textbooks are listed below in alphabetical order with annotations:

  • Bharath, AA, Introductory medical imaging. Morgan & Claypool Publishers, c2009 (intended for engineers). on-line
  • Carlton, RR, Adler AM, Principles of radiographic imaging: an art and a science. Thomson Delmar Learning, c2006 (for radiographers; lots on x-rays, not much else).
  • Dendy, PP, Physics for diagnostic radiology. Institute of Physics Pub., 1999 (principally for radiology registrars).
  • Guy, C and Ffytche, D, An introduction to the principles of medical imaging. Imperial College Press, c2005 (non-mathematical, accent on tomography).
  • Kevles, BH, Naked to the bone : medical imaging in the twentieth century. Rutgers University Press, 1997 (effects of developments on medicine and society)
  • Runge, VM, Nitz, WR, Schmeets, SH, The physics of clinical MR taught through images, Thieme 2009, on-line
  • Scally, P, Medical imaging. Oxford University Press, 1999 (intended for medical undergraduates, focus on radiology rather than imaging technology).
  • Shung, KK, Smith, MB, Tsui, B, Principles of medical imaging. Academic Press, 1992 (becoming dated).
  • Suetens, P, Fundamentals of medical imaging. Cambridge University Press, 2002 (intended for biomedical engineers).
  • Webb, A, Introduction to biomedical imaging. Wiley 2003 (includes some mathematics).
  • Wolbarst, AB, Looking within: how X-ray, CT, MRI, ultrasound, and other medical images are created, and how they help physicians save lives. University of California Press, c1999 (somewhat simplistic). on-line

Other resources

On-line resources at UTS Library
The following list, in alphabetical order, is indicative of the range of relevant periodicals available.

There are also numerous resources, often electronic, available at UTS Library that deal with clinical applications of medical imaging, e.g. in breast carcinoma or stroke.

Web resources
General:

Magnetic resonance:

Ultrasound:

Nuclear medicine