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Applied Radiographic Knowledge (M)

Module description

*Please note that Degree Apprenticeship programmes have variable start dates and modules are taught across the full year.

This module introduces you, in depth, to the relevant anatomy and physiology and the scientific concepts underpinning Medical Imaging with an emphasis on how this knowledge is utilised in practice.

The module commences with an attendance block at the University of Exeter with an emphasis on face-to-face learning. The module then runs over a 12 month period with two further block attendances across the year for further face-to-face learning. In the non-block weeks there will be protected ‘off the job’ learning (one day (7.5 hours) per week) supported by e-learning materials provided by the academic team. The full calendar of activities and assessment will be made available via the handbook. Annual leave may be booked in accordance with the requirements laid out in the handbook.

Module aims - intentions of the module

The aim of this module is to enable you to develop an in-depth knowledge of the essential multi-disciplinary sciences that underpin diagnostic radiography practice to encompass the full spectrum of routinely used medical imaging modalities.

During this module you will gain understanding of radiation biology and physics to ensure the safe and optimal use of radiation imaging techniques. You will learn about the range of applications of ionising radiation and be introduced to non-ionising imaging modalities. You will learn about the scientific concepts underpinning image formation, digital image processing and equipment as used in medical imaging. You will learn about the design of radiopharmaceuticals, contrast media and medicines used in imaging. During this module you will also learn about anatomy and pathology with particular reference to medical imaging.

Intended Learning Outcomes (ILOs)

ILO: Module-specific skills

On successfully completing the module you will be able to...

• 1. Demonstrate in-depth knowledge and understanding of ionising radiation and interactions with tissues, radiobiology, radiation protection and related legislation as applied to radiography and healthcare
• 2. Demonstrate in-depth knowledge and understanding of the basis of parameter selection, image receptor design, image formation, image optimisation and digital image processing and storage (including confidentiality and security considerations), as used in medical imaging departments.
• 3. Demonstrate in-depth knowledge and understanding of the physical principles, range and scope of common applications for the range of modalities (fluoroscopy, interventional, dental, Dual Energy X-Ray Absorptiometry, mammography, Computed Tomography, Radionuclide Imaging, Magnetic Resonance Imaging and Ultrasound)
• 4. Demonstrate in-depth knowledge and understanding of quality assurance and quality control tests typically undertaken in both ionising and non-ionising modalities.
• 5. Demonstrate in-depth knowledge and understanding of normal human anatomy including systems anatomy and normal physiology at the systems level with particular reference to medical imaging.
• 6. Demonstrate in-depth knowledge and understanding of principles of contrast media design (ionising and non-ionising radiations), radiopharmaceuticals and medicines used in imaging including governance, methods of administration and interactions with the human body

ILO: Discipline-specific skills

On successfully completing the module you will be able to...

• 7. Demonstrate reasoning and mathematical skills to support Level 7 work
• 8. Synthesise appropriate sources of information to develop own knowledge

ILO: Personal and key skills

On successfully completing the module you will be able to...

• 9. Manage time and prioritise competing workloads
• 10. Demonstrate problem solving skills

Syllabus plan

IONISING RADIATION, RADIATION PROTECTION
X-ray production: Bremsstrahlung and characteristic radiation
Radioactive decay (alpha, beta, gamma decay)
Biological effects of radiation at the whole body and cellular / molecular level
Radiation dose, radiation units, dosimetry (practice devices)
Derivation and application of dose reference levels
Protection of staff including personnel monitoring
Protection of patients, including dose recording, risk-benefit philosophy and constraints on practice

LEGISLATION
Current legislation (Ionising Radiations Regulations 2017, Ionising Radiation (Medical Exposure) Regulations 2017), Local Rules
Record keeping, information for patients

IMAGE FORMATION
X-ray interactions with tissues (Rayleigh scattering, photoelectric effect, Compton scattering, pair production)
Technical evaluation of images (spatial resolution, SNR, CNR, histograms etc.)
kVp, mA, mAs - impact of manipulation upon image appearances
Appropriate factor selection, image optimisation

DIGITAL IMAGING
Image receptor design, interactions of x-rays with image receptors, sources of noise and noise minimisation
Digital imaging: acquisition and processing as used in medical imaging departments
Look up tables, histograms and image enhancement including windowing
Equipment specifications and impact upon digital imaging system performance
Digital imaging manipulation tools (commonly used post-processing applications) and image co-registration
Telemedicine
Cyber security, information governance and General Data Protection Regulations relevant to medical imaging
Digital imaging storage – confidentiality, use of images for other purposes e.g. teaching / study
Digital imaging storage – DICOM, PACS.
Developments in digital imaging e.g. computerised pattern recognition

PROJECTION RADIOGRAPHY & FLUOROSCOPY
Equipment – x-ray tube, bucky, couch and other equipment design
Room layout – safe and efficient practice

MODALITIES – PRINCIPLES AND APPLICATIONS
2D techniques – underlying science, equipment, typical applications and relative role
Dental
Dual energy x-ray absorption (DXA).
Mammography.
Interventional imaging and procedures.
3D techniques (ionising) – underlying science, equipment, typical applications and relative role
Computed Tomography (CT)
Other modalities:
Underlying science, equipment, typical applications, relative role, safety considerations (including guidance / legislation)
Radionuclide Imaging (RNI), 2D, 3D
Positron Emission Tomography (+/- CT)
Ultrasound
Magnetic Resonance Imaging (MRI)

QUALITY ASSURANCE AND QUALITY CONTROL
Range of QA and QC tests typically undertaken in both ionising and non-ionising modalities including image receptors
Role of QA and QC in ensuring safe practice

ANATOMY & PHYSIOLOGY
Normal anatomy including developmental anatomy and anatomical variants (axial and appendicular skeleton – joints, associated musculature and other tissues, head, neck, thorax, abdomen – principal internal organs including surface anatomy)
Normal human physiology of the musculoskeletal, nervous, cardiovascular, respiratory, renal, digestive, sight, hearing, endocrine and reproductive systems, growth & development.

CONTRAST MEDIA (NON-IONISING), RADIOPHARMACEUTICALS AND MEDICINES USED IN IMAGING
Contrast Media Type i.e. ionic / non-ionic, macro-cyclic / linear
Contrast Media used in ionising and non-ionising radiation modalities including physical interactions that determine image appearances
Method of administration of contrast media
Radiopharmaceuticals – design and physical interactions
Medicines used in imaging – role, function
Methods of update, excretion and interactions with the human body of contrast media, radiopharmaceuticals and medicines used in imaging

Learning activities and teaching methods (given in hours of study time)

Details of learning activities and teaching methods

Formative assessment

Summative assessment (% of credit)

Details of summative assessment

Details of re-assessment (where required by referral or deferral)

Re-assessment notes

All assessment components must be passed at 50% or above. Each component of this module must be passed. Reassessment should be of the original assessment with additional preparation  and / or revisions to the original assignment made to bring performance up to passing standard. The referred assessment will be capped at the pass mark. The module mark will not be capped. If any component is not passed at the final referral attempt, the module is capped at 49%.

This programme runs to a non-standard timetable; assessment weeks and Assessment, Progression & Awarding Committees (APACs) for both initial and deferred assessments are held as per the programme’s published timetable.

Indicative learning resources - Basic reading

Ross & Wilson. (2018) Anatomy and Physiology in Health and Illness, 13edition ISBN-13: 978-0702072765

Ross & Wilson.(2018) , Anatomy and Physiology Colouring and Workbook (5th edition) ISBN 978-0-7020-7325-0

Graham D.T., Cloke P. and Vosper M. (2012), Principles and Applications of Radiological Physics (6^th edition), Churchill Livingstone, ISBN 9780702052156 electronic version also available

Carlton R.R. and Adler A.M. (2013), Radiographic Imaging Concepts and Principles (5^th edition), Delmar, ISBN 1473720524 electronic version also available

ELE – College to provide hyperlink to appropriate pages

Indicative learning resources - Web based and electronic resources

UK Statutory Instruments (2017), Ionising Radiation Regulations 2017, The Stationary Office, Available from https://www.legislation.gov.uk/uksi/2017/1075/contents/made,

UK Statutory Instruments (2017), The Ionising Radiation (Medical Exposure) Regulations 2017, The Stationery Office, Available from http://www.legislation.gov.uk/uksi/2017/1322/made, 

UK Statutory Instruments (2018), The Ionising Radiation (Medical Exposure) (Amendment) Regulations 2018, The Stationary Office, Available from http://www.legislation.gov.uk/uksi/2018/121/contents/made,  

The Health & Safety Executive (2018), Work with Ionising Radiation. Ionising Radiations Regulations 2017: Approved Code of Practice and Guidance, HSE Books, ISBN 9780717666621,

Indicative learning resources - Other resources

• Carter C. and Veale B. (2013), Digital Radiography and PACS (2^nd edition), Mosby Elsevier, ISBN 978-0323086448
• Blake G., Wahner H.W. and Fogelman I. (1998), The Evaluation of Osteoporosis: Dual Energy X-ray Absorptiometry in Clinical Practice (2^nd edition), CRC Press, ISBN 978-1853174728
• Kim, E. (2012), Handbook of nuclear medicine and molecular imaging: principles and clinical applications, World Scientific, ISBN 9789814366236
• Kremkau F.W. (2016), Sonography: Principles and Instruments (9^th edition), Saunders, ISBN 978-0323322713
• McRobbie D.W. et al. (2017), MRI from Picture to Proton (3^rd edition), Cambridge University Press, ISBN 9781107706958
• Powsner R.A. Palmer M.R. and Powsner E.R (2013), Essentials of Nuclear Medicine Physics (3^rd edition)., Wiley Blackwell,  ISBN 978-0470905500
• Society and College of Radiographers (2019), Safety in Magnetic Resonance Imaging, Society and College of Radiographers, ISBN 978-1-909802-31-5
• Westbrook C. (2018), MRI in Practice (5^th edition), Wiley Blackwell, ISBN 978-1-119-39196-8

Key words search

Medical Imaging; Radiation, Regulations, Pathology, MRI, US, RNI, PET-CT, Modalities, CT, X-Ray