Radiology introduction

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Radiology - introduction
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Purpose of training

• Provision of clinically relevant basic knowlegde
  regarding indications, proper algorythm and
  accuracy of diagnostic imaging and interventional
  radiology.

András Palkó
Zita Morvay
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Sources of information

• Textbook
• Gunderman RB Essential Radiology (2nd ed.),
  Thieme, New York, 2006
• Lectures
• Clinically oriented, slides available at
• www. szote.u-szeged.hu/Radiology/
• Seminars
• Clinically oriented, case-based
• Teaching files
• Appr. 800 images with comments on
• www. szote.u-szeged.hu/Radiology/

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Exam

• Core knowlegde textbook lecture seminar
• 1st semester MC test
• 2nd semester oral questions images
  available on the website
• Feed-back!!

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Radiology diagnostic imaging therapeutic
intervention guided by imaging procedures
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DIAGNOSTIC IMAGING

• Roentgen x-ray
  1895
• Cannon contrast material (bismuth) 1896
• Krause (barium)
  1904
• Graham brachial arteriography 1923
• cholecystography
  1923
• Swick i.v.pyelography
  1928
• Donald ultrasound (sonar) 1950
• Seldinger catheter-technique
  1953
• Hounsfield CT 1967
• Lauterbur MR
  1973

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Trends of development

• full digital imaging
• intelligent equipments
• 3D, virtual reality, functional imaging
• genetically modified, molecular markers
• biologically specific contrast materials
• PACS, neural network, automatic image reading and
  interpretation

- faster, easily generated, more relevant
information - shorter way to diagnosis
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Diagnostic imaging

• Introduction

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DIAGNOSTIC IMAGING

• Purpose create visible image of morphology and
  function of the human body
• Image visual information (visualization in 2 or
  3 D, vector, curve, spectrum, etc.)
• To bring about an image
• Energy has to be conducted to the body
• Interaction of the energy and the components of
  the body
• Detection of the modified energy
• Visualization of the detected pattern

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DIAGNOSTIC IMAGING

• Types of imaging
• transmission
• reflection
• induction
• emission

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DIAGNOSTIC IMAGING

• image generation
• image reading
• image interpretation (report)
• data processing and archiving

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DIAGNOSTIC IMAGING
clinical problem
consultation
indication examination
consultation
therapy
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DIAGNOSTIC IMAGING

• Methods
• x-ray (analog/digital, radiography, tomography,
• fluoroscopy)
• ultrasound (gray-scale, B-mode, Doppler,
  duplex,
• color, 3D)
• computed tomography (incremental v. helical)
• magnetic resonance imaging (SE, GE, EP,
  spectro, functional)
• (PET-CT)
• (optical imaging)
• (trans-scan)
• (thermography)

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X-ray imaging
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• Absorption of x-ray is influenced by
• wave-length of radiation3
• atomic number4
• density
• thickness

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patient
Radiography
X-ray tube
detector (film, dd)
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Fluoroscopy
image intensifier
detector (fluoro screen)
TV monitor
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negative (radiographic) image
positive (fluoroscopic) image
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collimation
X-ray
lesion
X-ray tube
shadow
body
detector
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X-ray
X-ray tube
object
shadow
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X-ray
X-ray tube
object
shadow
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object I.
X-ray
X-ray tube
object II.
shadow
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focus
object
X-ray tube
X-ray
(shadow)
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focus
object
X-ray tube
X-ray
(shadow)
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X-ray imaging

• magnifies
• distorts
• summarizes
• forgets

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X-ray imaging

• magnifies
• distorts
• summarizes
• forgets

The solution

• additional direction
• tomography

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Poor contrast resolution

• Solution
• low voltage
• contrast material
• other modalities

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The avalanche
PACS, RIS teleradiology
US MR fMR
intervention CT
MDS-CT
kettos k.
Ba iodine
non-ionic Gd US
fluorosc. image
intensifier DSA
DF
X-ray radiogr. tomography

PP, DDR
Magic mountain
1900 1925
1950
1975
2000
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DIAGNOSTIC IMAGING

• radio-physics
• radio-biology
• photochemistry, photography
• descriptive geometry
• informatics
• anatomy, pathology
• physiology, pathophysiology
• clinical sciences

• image
• information

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DIAGNOSTIC IMAGING
The past establishment of physical and
clinical basis invention of imaging
modalities The present improvement of imaging
modalities, integration of informatics The
future convergence and integration of
imaging modalities, dissociation of
imaging and reporting in time and space,
automated diagnostics
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• Questions of development
• is the application financable?
• high-tech high cost ?
• expensive unnecessary ?
• are the results applicable in practice?
• marketing or real need ?
• does it make sense?
• does better sensitivity automatically bring
  better
• specificity?
• does better imaging provide
• functional/cellular/molecular/genetical
• additional information ?
• does therapy improve ?
• does development fragmentate radiology?

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In God we trust everyone else must show data
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