FUNDAMENTAL MEDICAL IMAGING interpretation, management, and other tasks

INFORMATICS (e.g. Patient record)

Image Generation

◦ Medical imaging

◦ refers to the techniques and

processes used to create images
of the human body for clinical
purposes or medical science.

◦ Medical Imaging Informatics (Imaging

Informatics or Radiology Informatics)

◦ a subfield of radiology
informatics that has arisen in
recognition of the common Conventional Radiography
issues that pertain to all image
modalities and applications
once the images are converted
to digital form.

◦ It is devoted to the study of

how information about and
contained within medical
images is retrieved, analyzed,
enhanced, and exchanged
within radiology and
throughout the medical
enterprise.
Digital Radiography
Medical imaging informatics embraces the
following areas:

Image Generation : The process of generating

the images and converting them to digital form
if they are not intrinsically digital.

Image Manipulation: Uses pre-processing and

post-processing methods to enhance, visualize,
or analyze the images.

Image Management : Includes methods for

storing, transmitting, displaying, retrieving, and
organizing images.

Image Integration : The combination of images

COMPONENTS OF MEDICAL IMAGING
with other information needed for
INFORMATICS
 ◦ COMPUTER SCIENCE - the study
of processes that interact with data and
that can be represented as data in the
form of programs.
◦ Radiology Information System (RIS) –
◦ COMPUTER TECHNOLOGY – combines
the hardware of computers and
computer-controlled devices with
software—operating systems, authoring
tools, expert systems and courseware—
to support training technology.
◦ The study of process for storing and
retrieving information, especially
scientific or technical information.
designed for scheduling patients,
storing reports, patient tracking,
protocoling examinations, and billing.
RIS ties together all the computer
systems within the radiology
department.

◦ INFORMATION SCIENCE – a field ◦ Picture Archive and Communication

primarily concerned with the analysis,
collection, classification, manipulation,
storage, retrieval, movement,
dissemination, and protection
of information.
Information Technology
◦ INFORMATION TECHNOLOGY – the use
of computers to store, retrieve,
transmit, and manipulate data, or
information, often in the context of a
business or other enterprise.
Computer Science
System (PACS) – encompasses a broad
range of technologies necessary for the
storage, retrieval, distribution, and
display of images.
o Computers are an integral part of
modern radiology practice.
o They facilitate newer utilities like voice
dictation and image reviewing on hand-
held devices.

◦ Focused entirely on the efficiently

programming computers using
mathematical algorithms.

◦ In some medical imaging modalities, it

is impossible to produce images without
the aid of computers.

◦ “Brain” of Medical Imaging Informatics

Computer Technology

◦ Combines the hardware of computers

and computer-controlled devices with
software programs.

◦ Many of the modern methods of

scanning and imaging are largely based
IMAGING SCIENCE AND INFORMATICS
on the computer technology.

Information Science
What is imaging science and informatics?
  a subspecialty of  Medical Imaging plays a major role in
biomedical informatics. objectifying clinical presentations.

 to improve efficiency, accuracy,  Medical imaging serves as the basis for

usability and reliability of shared communication between
medical imaging services within the healthcare providers, detailing evidence
healthcare enterprise. of current and past medical findings.

 An understanding of medical imaging Medical Imaging Informatics:

informatics begins with:
From Theory to Application
 application toward diagnostic
and therapeutic clinical
assessment

 knowledge of medical imaging

Why do we need to study Imaging Science and

Informatics?

 It is imperative for Radiologic

Technologists (RTs) to fully understand
the impact and significance of the
emerging health information
technologies being used in medical
imaging in order to provide quality Sub-optimal Study Selection
patient-centered care and have greater  With the rapid changes in imaging
insight into the bigger picture of
technology, it is unrealistic to believe
healthcare’s future.
that a physician can always make up-to-
The shift to digital imaging technologies allows date if not optimal decision about
tremendous flexibility in manipulating image imaging exams, thus wrong study may
data, but also requires diligence to ensure the be given to a patient.
highest quality images are presented to the
Poor Acquisition
radiologist.
 Problems may arise due to poor
instrumentation, equipment calibration,
 TO PRODUCE THE HIGHEST QUALITY poor data acquisition methods or poor
IMAGES. technique.
 TO PROVIDE QUALITY PATIENT-
CENTERED CARE.
 TO IMPROVE EFFICIENCY, ACCURACY, Poor Interpretation
USABILITY AND RELIABILITY OF
MEDICAL IMAGING SERVICES.  Can be due to inadequate historical
Medical information, poor information
Ascertain Patient’s Condition on filtering/presentation, or
poor/mismatched skills by the reader.
 Find out what is wrong with the patient.
 Can be improved by providing users
with up-to-date facilities or by choosing
the best-matched readers.
Poor Reporting
 This lack of coordination is due to:
 Poor documentation of the
study result.
 Difficulties in communicating
the results of tests to referring
healthcare providers.
 These can lead to problems such as:
 Starting a treatment before a
definitive diagnosis.
 Duplicating diagnostic studies.
A Review of Basic Imaging Modalities
Projectional Imaging
 The genesis of medical imaging and
radiography started in 1895 with the
discovery of x-rays by Roentgen.
 Today, the use of x-ray projectional
imaging comes only second to the use
of laboratory tests as a clinical
diagnostic tool.
 X-rays are a form of electromagnetic
(EM) radiation, with a wavelength
ranging from 0.1-10 nm, which
translates to photons with an energy
level of 0.12-125 keV.
 Above a certain energy level (12 keV), x-
rays are able to penetrate different
materials to a varying degree: it is this
phenomenon that is taken advantage of
in projectional x-ray imaging.
 When a photon hits an atom, there is a
chance of interaction between the
photon and any electrons.
 There are essentially three different
ways that an x-ray can interact with
matter within the diagnostic energy
range:
 Photoelectric effect
 Compton effect
 Coherent scattering
Photoelectric Effect
 Interaction of a photon with a low-
energy electron. If the photon has
sufficient energy, then the electron is
separated from the atom, with any
excess energy from the photon being
transformed into the electron’s kinetic
energy.
 The emitted electron is referred to as a
photoelectron. Given the absence of an
electron in the lower energy levels, an
electron from a higher energy level
moves down to take its place; but in
order to do so, it must release its extra
energy, which is seen in the form of a
photon (characteristic radiation).
 This type of interaction typically occurs
with the absorption of low-energy x-
rays.
 Coherent Scattering

 X-ray can undergo a change in direction

but no change in wavelength (energy)

 Thomson and Rayleigh scatter are

examples of this occurrence.

 Usually less than 5% of the radiation

undergoes this effect.

 A fourth type of interaction is possible,

known as pair production.

 It involves high energy x-rays and

Compton Effect
elements of high atomic weight.
 Rather than being absorbed, when a
 Pair production occurs when the x-ray
high-energy photon collides with an
photon interacts with the nucleus, its
electron, both particles may instead be
energy being transformed into two new
deflected.
particles, an electron and positron.
 A portion of the photon’s energy is
 For the most part, pair production is
transferred to the electron in this
rare in medical x-rays given the high
process, and the photon emerges with a
level of energy needed.
longer wavelength; this effect is known
as Compton scattering .

 This phenomenon is seen with higher-

energy x-rays.

 Compton scattering is the major source

of background noise in x-ray images.

 Compton scattering is a cause of tissue

damage.

 The degree to which a given substance

allows an x-ray to pass through is
referred to as attenuation.

 Denser materials, particularly

comprised of larger atoms, such as the
calcium in bone, will absorb more x-rays
than soft tissue or fluids.
 A projectional image is thus formed by
capturing those x-ray photons that are
successfully transmitted from a source
through an object to a detector that is
designed to capture the photons.