Visit Report on the Queen Elizabeth Hospital

Visit Report on the Queen Elizabeth Hospital

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Visit Report on the Queen Elizabeth Hospital

Introduction

For my visit on the applications of physics, I went to Queen Elizabethhospital
on the 10th of November 2004. The Queen Elizabeth hospital operates
the largest critical care unit in Europe, which is combining intensive
therapy with high dependency units. The hospital situated in Selly Oak
is a distance of one and a half miles from the SellyOakHospital
between them there are approximately 5900+ employees. Queen Elizabeth
Hospital is aimed, to the adult population mainly in the West Midlands
and offers a range of health services; bone marrow transplant,
chemotherapy, cancer, renal and trauma services etc.

The QueenElizabethHospital has been ranked at three stars in 2001-02
and treats over 650,000 patients each year.

The two aspects of physics which I investigated were:

* Gamma Camera

* Ultrasound

Applications of physics.

* Gamma camera

The first application of physics that I witnessed was the Gamma camera
in the nuclear medicine department. This basically involves the
patient being injected with a gamma emitting-isotope, this radioactive
substance then sends back images of the internals of the patient. The
half-life of the isotope is to suit the time of the diagnostic tests
and the convenience of the patient so there isn't a lot of radiation
they are exposed to.

Below is an example of a gamma camera.

[IMAGE]

* Ultrasound

Ultrasound was another application of physics which I saw in QueensElizabethHospital
. The use of ultrasound which I saw was the ultrasound scan. This is
mainly used for pregnant women to see if the foetus has any
abnormalities, or check on progress and growth. The rays in ultrasound
have a very high frequency which is above the human audible range.

Here you can see an image made using ultrasound to see a foetus's
progress, growth and if the foetus has any abnormalities.[IMAGE]

Gamma camera.

Gamma cameras and Single Photon emission computerized Tomography
(SPECT) scanners are used for planer and tomographic imaging of gamma

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Related Searches

emitting radioisotopes in the body. Most imaging at QueenElizabethHospital
involves Thallium (Tc99m) and or technetium as a radioactive tracer
which gamma rays, which is or injected directly into the body.

A 'butterfly' (which so called because of its appearance), is used to
ensure that the injection of radioactive material Thallium Tc99m is
injected into the correct site on the patient. This allows the doctor
or nurse to see if the needle is inserted correctly before the
radioactive fluid is pumped into the patient.

[IMAGE]

When the injection is given it is very important that no radioactive
substance is let out. So the radionuclide in the syringe is shielded
to protect the person injecting the injection.

[IMAGE]

The gamma rays have electromagnetic radiation which is of very high
penetration power, so the gamma rays can penetrate through soft
tissue. Therefore more gamma rays exit the body and are available for
detection than interact with the patient's tissue. These can be
detected by gamma camera and the concentration of the radioactive
tracer being used. In various parts of the body be found out
definitely, ascertained.

The half life of Technetium T99m is 6 hours, which has a similar half
life to Thallium (Tc99m) because; both are used as radioactive tracers
and have to suite the time for the diagnostic procedures and for the
convenience of the patient. The graph is shown below.

[IMAGE]You can clearly see that the radioactive decay of Thallium (Tc99m)
has a half life of 6 hours; on the graph the activity/Bq halves at 6
hours. The half life is long enough and short enough for the
experiment to take place. It is long enough for the diagnostic
procedures to take place and it's short enough for the patient not to
be inconvenienced by the excessive remaining radioactive material for
too long after the diagnostic procedure.

Gamma rays cannot be focused by refraction, (like light rays can be)
which is why a lead collimatoris used to direct the gamma rays, from a
point on the patient to a point on the sodium iodide crystal. The
collimator absorbs gamma rays emanating from other parts of the body,
before crystal is activated ensuring, that the rays from the relevant
part of the body hit the crystal. In the image below you can see an
example of this.

The scintillation crystal is the sodium iodide crystal.

Once in the body the specificity of the gamma camera is aimed at the
region where the image is to be taken. The gamma emitting facilitates
imaging of the physiological function of the patients. Many devices
include signal analysis and display equipment and other accessories.

Traditional gamma cameras that use a scintillation crystal and
photomultiplier tubes are based on a rather old design dating as far
back as the 1960's. This is the design that is used in Queens
Elizabeth. Scintillation counters consist of a detector system and a
processing display unit. The detector system is made up of sodium
iodide crystal coupled to a photomultiplier tube. When gamma ray
photons strike the crystal converts the each gamma ray into light one
at a time or scintillation occurs.

This light is detected using a photomultiplier and changed into an
electrical output so that it can be displayed on a monitor. The
electrical output can be translated into colour coded graphical
display using electronic circuitry and the camera display can be made
on a monitor and videoed. Hard copies of the scans can then be taken
and compared. Then the electrical output can be translated into colour
coded graphical display using electronic circuitry.

[IMAGE]

In the diagram above you can see that the processes taking place.

Below are images which show how a scan of the brain would look on a
grey scale and also on a false colour scale.

[IMAGE]

In the diagram above you can see how the monitor displays the image
and also by reading the text box, you would how the colour image is
produced by the computer. If the gamma camera was aimed at an angle to
diagnose this view of the brain this is an example of what would be
seen of a patient's brain scan.

Moreover if a scan was taken of patient with a tumor in the vertebrate
then you would see a grey colour for the tumor, and when a false
colour image is used then the tumor would be seen as red/orange
colour.

Other uses of gamma camera.

Other uses of a gamma camera could be to is a patient is suitable to
have surgery. An example of this is explained below.

[IMAGE] [IMAGE]

Fig 1. Fig 2. Image of a normal heart.

[IMAGE]

Gamma cameras can also be used to detect if the patient will benefit
from heart surgery. In fig 1, there is image of a heart of patient,
which has had myocardial infraction (heart attack). The arrows in fig
1 are pointing to areas on the heart where there is damaged by a heart
attack, which indicates 'dead' myocardial tissue. Therefore the
patient will not benefit from heart surgery, but other methods of
treatment may be prescribed to the patient.

Risks

The energy of the emitted gamma photon is about 140000 eV (1 eV = 1.6
x 10-19 J), an energy dose is typically between 2 and 4. 1 Sv
radiation that deposits 1J per kg in a patient. The quantity (amount)
of energy absorbed per kg of human tissue is 1 rad (1 rad = 1 x 10-2
J/kg).

The average male weighs approximately 80 kg. Thereby the amount of
energy absorbed by the body is 80 x (1 x 10-2 ) = 0.8 J

As stated before the radiation dose is typically between 2 and 4 mSv.
The bone scan, itself will result in a dose of 2.5 mSv. 1Sv is a
radiation that deposits 1J per kg in the patient. Multiply this by the
2.5, so the radioactive substance in the body deposits 2.5 J/kg. If I
then multiply this by 80 I will get 200J.

This equation suggests that not much radiation is absorbed by the body
at all. The body absorbs only 0.8J from a dose that deposits 200J.
0.4/200 x 100= 0.4%,only of the energy emitted is actually absorbed by
the body of the patient being diagnosed for treatment.

Future developments.

1. After years of research Digirad has finally developed aspects of
its patented technologies into the worlds first most solid-state gamma
camera, called the 2020tcImager. This design is unique because it
combines the advantages of solid-state reliability with improved
features to provide enhanced image contrast. Moreover there is finally
the removal of the large photomultiplier tubes. There are many reasons
that make solid-state detectors ideal for a gamma camera, these
include:

* Low cost material production

* High detection efficiency

* Improved signal-to-noise ratio

* Solid-state reliability

Bibliography.

Below is list of sites that I used to acquire diagrams or information
for this report:

http://www.uhb.nhs.uk

http://www.physics.ubc.ca

http://www.healthdiscovey.com

http://faculty.washington.edu

http://www.sielimaging.com/images/gamma_cam1.jpg

http://www.biomed.org/pet.html#what

http://www.digirad.com/about_news-detail.asp?id=15

http://www.cyberphysics.pwp.blueyonder.co.uk/topics/physics/radioact/Radio/humanact.htm
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