ANDREW JOHNSTONE B3459426 S809 TMA1 1 (a).

The hand is relatively easy to image compared to other parts of the body primarily because of the thickness of it. The X-Ray transmitter and the detector can be placed very close to each other. The transmitted power can be kept relatively small because of this. Being able to move the detector closer to the source means that there is more leeway in finding the optimal positioning of transmitter, hand and detector to minimise the effects of scattering. The physiology and anatomy of the hand also make the hand relatively simple to image. The hand can be laid relatively flat and is hugely articulate in that it can be positioned and held still. The dimensions of the hand also mean that the hand can be brought closer to the transmitter because a greater field of view is not needed thus increasing beam density. The smaller the detector the lesser the chances of wider angle scattering on the quality of the image. (b). Beam intensity.

I = I 0 exp i ( i xi ) where : I is the intensity after the ray has passed through a distance of x I 0 is the initial intensity

is the linear attenuation coefficient

(c). Beam intensity through a specific part of the hand containing: Muscle thickness 15 mm Cortical bone 5 mm Compared to a specific part containing 20mm of muscle.

ANDREW PAUL JOHNSTONE B3459426 S809 IMAGING IN MEDICINE Page 1 of 9

Muscle and bone:

I = I 0 exp i ( i xi ) I 0 = 1(constant)

1 = 0.028 @ x1 = 15mm (muscle) 2 = 0.132 @ x 2 = 5mm (bone)

I= exp {(0.028x15) + (0.132x5)} = e1.08 = 30.34 Percentage intensity passing through medium =
Muscle only:

Intensity out 0.34 x 100= x100=34% Intensity in 1

I = I 0 exp i ( i xi ) I0 = 1

1 = 0.028 @ x1 = 20mm (muscle)

I = e ( 0.028x20) = e 0.56 = 0.57 Percentage intensity passing through medium = Intensity out 0.57 x 100= x100=57% Intensity in 1

23% more intensity passes through the medium not containing bone this is sufficient to distinguish between bone and flesh. (d). Not removing the scattered radiation in an x ray would result in a blurring of the image, this would diminish the overall spatial resolution of the image. (e) (i) Roentgens image would be show less definition between different tissues as the primary attenuation differences were reduced. The exposure time to the radiation would have to be increased and would cause over exposure of the image. (ii) Frau Roentgens hand would have to be exposed to the radiation source for longer thus increasing the radiation dosage and tissue damage.

ANDREW PAUL JOHNSTONE B3459426 S809 IMAGING IN MEDICINE Page 2 of 9

2. A description of ultrasound as a kind modality is appropriate, the productive points are: Ultrasound does not use ionising radiation. Lightweight and portable and can be taken to the patient. Can provide instant live feedback and reassurance for example in pregnancy The patient does not have to be man handled Relatively quiet Non enclosing such as in CT and MRI Minimally invasive Can be used with children with parents present and integrated into play Parents can hear their unborn child Live imaging used as a guide during surgery to minimise discomfort, some patients gain relief in operative procedures if they are allowed to watch what is going on. Relatively unobtrusive in the diagnosis of complaints in personal areas e.g. testicles Painless Especially useful in trauma and in conflict zones where concussion or strike can cause internal rupture.

3(a). A constant supply of Mo-99 is important because it is the parent radionuclide to Technetium-99m (Tc-99m). (Tc-99m) is highly sought after as it emits Gamma radiation with a photon energy of 140 keV which is easy to detect using conventional x ray detection. It also has a short biological and physical half life so it is flushed from the body relatively quickly. (b) (i)

Figure 1. Radionuclide generator [1] A method called column chromatography is used in most Tc-99m generators, this involves pulling a saline solution through a column of alumina adsorbed with the parent radionuclide Mo-99. The resulting eluate is a combination of the original
ANDREW PAUL JOHNSTONE B3459426 S809 IMAGING IN MEDICINE Page 3 of 9

saline plus the daughter radionuclide Tc-99m. Because of the half life of the Tc-99m and the time that it takes to produce enough of the element from the decay of the parent source , the generator or cow is milked twice a day at least 6 hours apart. The useful life of one of these generators is recommended by the manufacturer [1] at 3 half lives of the parent which is approx one week. The whole system is encased in a lead shield. (ii)

99 42

m Mo 9943Tc + +

99 m 43

Tc 99Tc + 43

(c) Web of Science [2] Topic. Molybdenum. Author. Ballinger Abstract: Most nuclear medicine studies use Tc-99(m), which is the decay product of Mo-99. The world supply of Mo-99 comes from only five nuclear research reactors and availability has been much reduced in recent times owing to problems at the largest reactors. In the short-term there are limited actions that can be taken owing to capacity issues on alternative imaging modalities. In the long-term, stability of Mo-99 supply will rely on a combination of replacing conventional reactors and developing new technologies. Ballinger, JR. (2010). Short- and long-term responses to molybdenum-99 shortages in nuclear medicine. British Journal of Radiology. 83(995), 899-901.

ANDREW PAUL JOHNSTONE B3459426 S809 IMAGING IN MEDICINE Page 4 of 9

4 (a) Frequency of precession (Larmor Frequency)

Hydrogen

=B
where : = Larmour Frequncy Hz B = Magnetic field strength T = Gyromagnetic Ratio MRI = 3.0T (compared to the earths magnetic field of 5x105T ) =42.58MHz x 3 = 127.74 Mhz

(b) Number of pixels = 5480 Average Greyscale = 154.107 (c) MRI Proton Density 1 Phantom, Area 5480 Pixels Sample % Water Average Greyscale Value C1 50 154.107 C2 60 165.075 C3 70 176.624 C4 75 183.569 Water 100 219.876 Unknown 178.849

Figure 2. Table of Average Greyscale Results for Various Samples

ANDREW PAUL JOHNSTONE B3459426 S809 IMAGING IN MEDICINE Page 5 of 9

Figure 3. Average Greyscale against Percentage Water, MRI Proton Density 1 Phantom Figure 3. shows the plotted graph for samples C1 to C4 plus the water control sample. The unknown sample is marked and annotated. Average Greyscale Value is directly proportional to Percentage Water Content. (d) From the graph shown at Figure 3. The estimated water content of the Unknown Sample is approximately 72%

Figure 4. Image J Histogram Analysis of Unknown Sample. Greyscale Value of Unknown Sample = 178.849 6.216 5(a)
ANDREW PAUL JOHNSTONE B3459426 S809 IMAGING IN MEDICINE Page 6 of 9

(i) Equivalent dose:

H T = WR DT Sieverts (Sv) Where: HT = Equivalent Dose to Tissue. WR = Radiation Weighting Factor DT = Absorbed dose to tissue Since DT = 4.5mGy and WR = 1 for X rays HT = 1 x 4.5x103 = 4.5x103Sv (per breast)
Effective dose:

E = WT H T Sv Where : WT = Tissue Weighting Factor HT = Equivalent Dose to Tissue Since WT = 0.12 for breast and H T = 4.5mSv E = 0.12 x 4.5x103 = 540x10 6Sv (per breast)

ANDREW PAUL JOHNSTONE B3459426 S809 IMAGING IN MEDICINE Page 7 of 9

(ii) Background Equivalent Radiation Time

BERT( yrs ) =

effective dose (mSv) Uk annual background radiation level(mSv/yr)

0.54x10 3 BERT = = 0.2 years 2.7x10 3 assuming 1 year is 365 days BERT = 0.2 x 365 = 73 days
(b) The women would be subject to indirect DNA damage due to the low radiation weighting factor of x rays and the high tissue weighting factor of breasts. Any deterministic effects are unlikely as the amount of radiation received is well below any threshold factor however there is always the chance of a stochastic effect. (ii) Population odds.

Total effective dose = 3 x 0.54mSv=1.62m Sv Single value of risk coefficient for thewhole population(except for developingchild)=5% per Sievert. [3].
Risk of Stochastic effects(%)=1.62x103 x5= 0.0081%

Population odds =

100 100 = = 12345.679 Risk 0.0081

Increased lifetime risk ; 1 in 12346 peope l

(iii) Risk of death from smoke fire or flame = 1 in 1200. [4]. Risk of death from 3 mammograms in 10 year = 1 in 12346 people The women are approximately 10 times more likely to die from smoke fire or flame than of 3 mammograms in 10 years.

ANDREW PAUL JOHNSTONE B3459426 S809 IMAGING IN MEDICINE Page 8 of 9

References. 1. http://www.medcyclopaedia.com/library/topics/volume_i/r/radionuclide_generator/dra dionuclide_generato_fig1.aspx (accessed 01/02/2011) 2. http://apps.isiknowledge.com/full_record.do? product=UA&search_mode=GeneralSearch&qid=1&SID=Q2gg1E4d2JiGaKogIAF&p age=1&doc=1&colname=WOS (accessed 01/02/2011) 3. The 2007 Recommendations of the international commission of Radiological Protection ICRP publication 103, 2007. Annals of the ICRB vol 37 pp 1-332. 4. US National Safety Council, 1995.

ANDREW PAUL JOHNSTONE B3459426 S809 IMAGING IN MEDICINE Page 9 of 9