Study-Unit Description

Study-Unit Description


CODE MPH3009

 
TITLE Medical Physics and Radiation Protection in Nuclear Medicine and Radioisotope Cyclotron Facilities (Minor)

 
UM LEVEL 03 - Years 2, 3, 4 in Modular Undergraduate Course

 
MQF LEVEL 6

 
ECTS CREDITS 5

 
DEPARTMENT Medical Physics

 
DESCRIPTION This study-unit applies what was learned in the previous core units to the specialty of Nuclear Medicine and Radioisotope Cyclotron Facilities at a MINOR level. It will lay the groundwork for students to be able to specialise in this area at Masters level. The unit includes both diagnostic and therapeutic nuclear medicine. Owing to the rapid expansion of Positron Emission Tomography (PET) within nuclear medicine facilities the unit is further enhanced with content regarding cyclotron facilities for radioisotope production for use in PET. The unit follows the recommendations regarding core and specialist Nuclear Medicine expertise to be found in the EC documents 'European Guidelines on the Medical Physics Expert' and 'Requirements and methodology for recognition of Radiation Protection Experts'.

Study-unit Aims:

This study-unit aims to:
- Familiarise students with devices used in NM, relative technical strengths and limitations, performance indicators, methods of optimization of use and quality control;
- Review in detail radiation detectors used in NM and associated performance indicators.(e.g. energy resolution, sensitivity, spatial resolution, temporal resolution) and procedures for count corrections;
- Introduce to students the principles of radiopharmaceutical preparation and QC, radionuclide radionuclide production in cyclotron facilities;
- Demonstrate calculation of doses using the MIRD scheme and software tools such as OLINDA;
- Discuss the need for, and use of radiation risk assessments in NM and the assessment of dose to workers and public resulting from the use of sealed and unsealed radiation sources, disposal of radioactive waste, transportation of radioactive substances and cyclotron facilities;
- Discuss the key considerations in the design of a NM facility that optimise radiation safety of workers and public;
- Familiarise students with the role of MPE, RPE and RPO in NM.

Learning Outcomes:

1. Knowledge & Understanding
By the end of the study-unit the student will be able to:

- Discuss common NM devices/procedures and their variants in diagnosis and therapy; including general indications and contra-indications for NM procedures and risk/benefit justification;
- Discuss the functioning of the radiation detectors and electronic modules specific to NM and associated performance indicators.(e.g. energy resolution, sensitivity, spatial resolution, temporal resolution);
- Describe the characteristics of a NM counting system including procedures for correction and quantitation, effect of background counts and minimum detectable activities;
- Discuss the various devices required within the context of patient dosimetry including probes, well counters, dose calibrators;
- Describe briefly the principles of compartmental analysis;
- Discuss radiobiology applications for patient dosimetry in the context of NM therapy;
- Discuss how cumulated activity is calculated from time-activity curve including curve fitting algorithms and function optimization;
- Discuss the role of multiple time-point imaging for patient dosimetry;
- Discuss the role and influence of attenuation, background and scatter corrections/geometry/shielding/collimators/dead time correction, in all devices involved in activity measurements;
- Discuss the influence of the equipment settings (e.g. choice of energy windows, collimators, scan duration, count statistics) on activity results and how temporal sampling (scheduling of image acquisition) affects the results obtained;
- Discuss the principles of radiopharmaceutical preparation and QC;
- Discuss the use of techniques for the estimation of dose in the context of patient specific radionuclide therapy; use of DVH and isodose curve;
- Determine doses using tools such as OLINDA; describe briefly the MIRD scheme;
- Describe briefly basic methods for dose optimization for both diagnostic and therapeutic procedures;
- Discuss how therapeutic exposures are managed in both inpatient and outpatient contexts;
- Discuss the need for, and use of radiation risk assessments in NM and the assessment of dose to workers and public resulting from the use of sealed and unsealed radiation sources, disposal of radioactive waste, transportation of radioactive substances and cyclotron facilities;
- Discuss the application and use of good radiation safety practice and appropriate personal protective equipment;
- Discuss the key considerations in the design of a NM facility that optimise radiation safety of workers and public (e.g. imaging, non-imaging or in-vitro laboratory procedures, radionuclide therapy, radiopharmaceutical production);
- Discuss the role of designated RPE and RPO in radiation safety in NM; local rules;
- Discuss the institutional framework for Quality Assurance (QA) in a NM department, the concept of reference sources, both internal and external for absolute radioactivity determination, QC for production of isotopes and synthesis of radiopharmaceuticals; and
- Describe cyclotron facilities and techniques for radionuclide production.

2. Skills
By the end of the study-unit the student will be able to:

- For each NM device: Extract quantitative data from images including parametrical data and select appropriate phantoms/test tools to QC devices used in NM;
- Perform basic dosimetric calculations using the MIRD formalism;
- Use appropriate statistical techniques to calculate uncertainties;
- Elicit information from DICOM file headers;
- Recognize normal physiology as well as pathology in images;
- Calculate cumulative activities (incl. curve-fitting techniques);
- Participate in the design of a patient specific treatment plan;
- Apply the concepts of justification and optimization;
- Apply local European/National laws, regulations, recommendations and standards related to patient/occupational/public safety;
- Classify appropriately radiation areas; and
- Take measurements to verify that occupational/public doses are in compliance with legislation.

Main Text/s and any supplementary readings:

Main
- IAEA. (2014). Nuclear Medicine Physics - A Handbook for Teachers and Students.
- IAEA. (2011). Clinical Training of Medical Physicists Specializing in Nuclear Medicine. Training Course Series 50.
- Hoskin, P. (2007). Radiotherapy in Practice: Radioisotope Therapy. OUP.
- Martin C. J. & Sutton DG. (2015). Practical Radiation Protection in Healthcare. OUP.
- Cherry S. R., Sorensen J. A. & Phelps M. E. (2012). Physics in Nuclear Medicine. Elsevier-Saunders.
- Emerald-Emit Project. (2003). Project website: http://emerald2.eu/cd/Emerald2/

Supplementary
- Hamilton D. I., Riley P. J. (2004). Diagnostic Nuclear Medicine: A Physics Perspective. Springer.
- Sharp P. F., Gemmell H. G., Murray A.D. (2005). Practical Nuclear Medicine. Springer.
- Hoskin P. J. (2007). Radiotherapy in practice - Radioisotope therapy. OUP.
- Knoll G. F. (2010). Radiation Detection and Measurement. Wiley.

 
STUDY-UNIT TYPE Lecture, Independent Study & Tutorial

 
METHOD OF ASSESSMENT
Assessment Component/s Assessment Due Sept. Asst Session Weighting
Examination (3 Hours) SEM1 Yes 100%

 
LECTURER/S Sam Agius

 

 
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