OPTION TOPIC – MEDICAL PHYSICS

1. The properties of ultrasound waves can be used as diagnostic tools

Identify the differences between ultrasound and sound in normal hearing range

 Ultrasound is a very high frequency sound. Ultrasound waves are sound waves that have a
frequency above the range of human hearing, that is, greater than 20 000 hertz.
 A compromise on the frequency used must be made because the absorption of the wave
increases as the frequency increases. For example, a 50MHz ultrasound does not penetrate as
well through tissue as a 10MHz ultrasound as the tissue absorbs the ultrasound; however in
small penetration organs such as blood vessels very high frequencies can be used.
 For these reasons medical diagnosis uses ultrasound in the range of 1MHz to 10MHZ.

Describe the piezoelectric effect and the effect of using an alternating potential
difference with a piezoelectric crystal

 An ultrasound transducer is a device that produces and detects ultra sound.

 The production and detection of ultrasound is relied on one main component, the
piezoelectric crystal. The production of ultrasound is as follows. An alternating voltage is
directed towards the piezoelectric crystal causing the crystal to vibrate rapidly (contracting
and expanding)- [note that electrodes cause the voltage to turn into an alternating voltage].
The frequency of the vibration is at the same frequency of ultrasound. Effectively the
piezoelectric crystal has converted electrical energy into mechanical energy which causes the
crystal to vibrate producing an ultrasound. This is called the piezoelectric effect and can be
used to produce any ultrasound frequency.
 When the ultrasound is reflected back off a surface, it hits the crystal causing it to vibrate. The
vibration caused produces an alternating voltage at the same frequency as the ultrasound.
Thus the transducer can be used to produce and detect ultrasound.
 In summary Piezoelectric crystals convert an oscillating potential difference applied to the
crystal into a mechanical vibration producing an ultrasound (and an ultrasound to a
mechanical vibration into an oscillating potential difference).

Ultrasound <---Vibrations <----Piezoelectric effect

------<------- potential difference

(Reflected off surface)Vibrations ------------> ----------------->

 When a compression part of the wave meets the surface of the crystal, it causes the crystal to
contract and when a rarefaction meets the surface the crystal expands.
 An ultrasound detects reflected signals from different body structures. A computer then
analyses the signal to obtain information about the location of the structures to produce an
image.

Structure: (get diagram)

 There are electrodes on either side of the piezoelectric crystal which causes the voltage to be
an alternating one allowing the crystal to vibrate.
 Behind the piezoelectric crystal is a backing block which dampens the vibration of the crystal
 Common Piezoelectric crystals are quartz, Rochelle salt and certain ceramics such as zirconate
titanate (PZT).

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Define acoustic impedance: Z = pv and identify that different materials have different
acoustic impedances

 The acoustic impedance of a material is a measure of its resistance to the propagation of

sound waves. Therefore the higher the acoustic impedance of a material, the more resistance
it has to the propagation of sound waves.
 Acoustic impedance is mathematically defined as:
Z = pv
where: Z= acoustic impedance (kgm-2s-1 or rayls106 kgm-2s-1)
p= density (kgm-3)
v= velocity of sound in material (ms-1)
 From the formula above, acoustic impedance depends on the speed of the wave in the
medium and the density of the medium. Thus different media have different acoustic
impedances.
 Acoustic impedance is commonly measured in rayls where 1 rayl is 10 6 kgm-2s-1 .

Material Acoustic impedance Z Z (rayls i.e. 10^6 kg.m-2.s^-1)

(kg.m-2.s-1)
Air 400 0.004
Fat 1380000 1.38
Water (50C) 1540000 1.54
Brain 1580000 1.58
Blood 1610000 1.61
Kidney 1620000 1.62
Liver 1650000 1.65
Muscle 1700000 1.70
Lenses of eye 1840000 1.84
Skull bone 7800000 7.80
Aluminium 18000000 18.00
Mercury 19700000 19.70
Brass 38000000 38.00

Describe how the principles of acoustic impedance, reflection and refraction are applied
to ultrasound

 When ultrasound meets an interface between two different mediums, the wave undergoes
reflection, transmission (refraction) and absorption. The greater the difference in acoustic
impedance of the media, the more energy will be reflected, forming an echo. The echo is
detected which forms an image of the organ.
 As sound waves travel from one medium to another, the amount of reflection and refraction
is determined by the difference in acoustic impedance of the two media
 Ultrasound cannot produce an image pass the bone, as the ultrasound signals are reflected
strongly from a tissue-bone interface due to the large difference in acoustic impedance, so
they do not reach the tissue beyond the bone and therefore cannot give information about
this material. Hence ultrasound cannot be used to image the brain through the skull.

Define the ratio of reflected to initial intensity as:

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  When a sound wave strikes a medium, the amount of reflection is given by the ratio of the
intensity reflected back (Ir) to the initial incident intensity on the surface (Io).

 This is mathematically expressed as:

 Where: :
Ir = intensity of the reflected beam
Io= intensity of the incident/initial beam
Z1= acoustic impedance of medium 1
Z2= acoustic impedance of medium 2
 This formula indicates that, the greater the difference in acoustic impedance between the two
media, the greater will be the reflected proportion of the incident ultrasound wave.
 The percentage of the incident signal being reflected at the interface is given by the equation :
R = [Z2- Z1]^2 / [Z2+ Z1]^2 x 100%
 And thus the percentage being transmitted is 100% - the previous answer.

Identify that the greater the difference in acoustic impedance between two materials,
the greater is the reflected proportion of incident pulse

 From the formula above, it can be seen that the greater the difference in acoustic impedance
between the two media, the greater is the reflected proportion of the incident pulse.
 This is what happens when ultrasound is directed through the air to the skin. To minimise this
reflection at the skin surface, a gel with acoustic impedance similar to that of skin is placed on
the skin.

Describe the situations in which A scans, B scans, phase scans and sector scans would be
used and the reasons for the use of each

 Different types of scans are chosen to suit particular purposes.

A – scans (Amplitude mode)

 An A-scan is a range measuring system (measures depth) that records the time for an
ultrasonic pulse to travel to a part of a body and be reflected back.
 In an A-scan the ultrasound is directed into the body in one line and the reflected signal is
detected.
 In this way, body features can be determined by analyzing how long it takes to transmit the
signal and the time it takes to reflect back. The longer it takes the larger the wavelength.
Further the intensity of the beam adds further information of what material is the ultrasound
travelling through. The intensity of the reflected beams is plotted on a graph as a function of
time. The higher the intensity of the reflected beam the larger the amplitude.
 The A-scan shows only one dimension: the depth (i.e the time it takes the ultrasound to travel
and reflect back)
 A scans are used in the diagnosis for eye disease.

B-scans (Brightness mode)

 In a B-scan the intensities of the reflected ultrasound are represented as spots of varying
brightness, the more intense the reflected signal, the brighter the spot.

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  B-scans produce a 2-D cross section of a body part. This is achieved by moving the transducer
probe, through a series of angles, where an image is produced on an electronic screen.

Sector scans
 Sector scans are scans of a fan-shaped section of the body. They are made up of many B-
scans, which build up and image of the sector in the body through a series of dots of varying
intensities.
 Modern scanning techniques use an array of transducers very close together in the one probe
head. This enables very clear images to be produced and also allows the possibility of real
time scans (scans faster than 16 fps). Real time scans allow movement to be monitored and so
are used to examine, for example, foetal movement or heart movement.

Image of a sector scan:

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Phase scans:
 A phase scan is a scan produced using many transducers (up to several hundred). The phase
difference in transmitting the ultrasound wave from each transducer may be varied to
produce this type of scan.
 These transducers may be fired simultaneously or can be fired in close succession, so that
each wave front is slightly out of phase from the previous. By changing the time between the
firing of the transducers, the phase difference of the wave and the direction of the ultrasound
can be altered.
 The firing of the wave from the transducer is electronic and therefore very accurate, when the
reflected wave returns; it arrives at different times at each transducer.
 This allows the reflected signal to be analysed by the computer to which an image is
produced.
 Phase scans are the most common scanning technique used today,

Describe the Doppler Effect in sound waves and how it is used in ultrasonics to obtain
flow characteristics of blood moving through the heart

 The Doppler Effect is the apparent change in frequency observed when there is relative
movement between a source of a sound and an observer.
 Say for example there is a stationary source which is a transducer and a moving observer –
the blood cells. If the red blood cells, are moving away from the transducer, then the
reflected waves have a longer wavelength and a lower frequency than the incident wave.
However if the red blood cells are moving towards the transducer, then the reflected waves
have a shorter wavelength and a higher frequency than the incident wave.
 The frequency difference between the incident and reflected wave is called the Doppler shift.
 In summary, Doppler ultrasound provides two pieces of information about blood flow:
o The direction of the blood flow relative to the transducer can be determined whether
the reflected wave’s frequency has increased or decreased from the incident wave. If
it has increased then, the blood flow is moving towards the transducer, if it has
decreased the blood flow is moving away from the transducer. In other words the
direction of the blood flow relative to the transducer can be determined whether the
Doppler shift has increased or decreased.
o The size of the shift or change in frequency indicates the velocity of the blood flow. In
other words if there is little change in frequency, then this indicates there is normal
blood flow. If there is a large change in frequency, this could indicate that the patient
is in cardiac arrest, heart attack, blocked artery or even dead.

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Outline some cardiac problems that can be detected through the use of the Doppler
effect

 Echo-cardiography is the use of ultrasound to diagnose heart (cardiac) problems. The

reflection (echo) is detected from cardiac structures such as valves and heart muscle walls.
From this, the condition of the heart and its components can be determined. Heart problems
using this method include heart valve infection, heart tumours and blocked arteries.
 It determines the location of these problems and is also used in foetal heart monitoring.

Students:

Solve problems and analyse information to calculate the acoustic impedance of a range
of materials, including bone, muscle, soft tissue, fat, blood and air and explain the types
of tissues that ultrasound can be used to examine.

Gather secondary information to observe at least two ultrasound images of body organs

Image of a foetus

Identify data sources and gather

information to observe the flow of blood
through the heart from a Doppler
ultrasound video image

 To improve the information displayed

with Doppler ultrasound, the computer
can add colour to represent some vital
features. For example, blood that is

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 flowing towards the transducer is coloured red and flowing away is blue. The speed can be
indicated by variations in brightness.

Identify data sources, gather, process and analyse information to describe how
ultrasound is used to measure bone density

 Ultrasound measurement of bone density is as follows:

o The patient inserts a foot into a warm water bath and ultrasound waves are directed
through the heel bone from a transducer and similarly detected by the transducer.
o The speed of the ultrasound through the bone and the ultrasound attenuation
(degree of absorption) are measured. Normal bone has a higher speed of ultrasound
and larger attenuation than an osteoporosis bone.
o Speed and attenuation are combined to give an index from which an estimate of heel
bone mineral density is reported.

Solve problems and analyse information using:

and

2. The physical properties of electromagnetic radiation can be used as diagnostic tools

Describe how X-rays are currently produced

 X-rays are electromagnetic waves of very high frequency and very short wavelength, in the
range of 0.001nm to 10nm. When X-rays pass through the body, energy is absorbed by the
body tissue and the intensity of the beam is reduced.
 Denser material, such as bone, absorbs more X-radiation.

Production of X-rays:

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 1. The production of X-rays is produced in an evacuated tube. The cathode is a filament of wire
through which a current is passed. Electrons are emitted from the hot filament and a metal
focusing cup directs the electrons towards the anode.
2. The very high potential difference ranging from 25000 to 250 000 volts between the cathode
and the anode accelerates the electrons to the anode.
3. The anode is usually made of tungsten that can withstand the high temperatures generated.
When the electrons strike the tungsten they are absorbed and some of their energy is
converted into X-rays. By placing the tungsten target (anode) at an angle usually 45 degrees,
this ensures that the X-ray beam travels perpendicularly relative to the electron beam,
emerges through the side wall of the tube.

 The production of X-rays is very inefficient as approximately 99 percent of the electron’s

energy is converted to heat in the anode with only 1 percent being converted into X-rays.
 Since 99 percent of the electron’s energy is converted into heat, it is important to prevent the
anode from overheating melting. Copper is used for the anode mountings, and the circulation
of oil around the anode helps it to cool down. Cooling can also occur by rotating the target at
a rapid rate of 3600 rpm, allowing the heat produced to be distributed over a large area.

Compare the differences between ‘soft’ and ‘hard’ X-rays

 The penetrating power or ‘hardness’ of the x-rays depends on the energy with which the
electrons hits the target. This is in turn dependant on the accelerating potential.
 It follows that the intensity and the hardness can be independently controlled by varying the
accelerating voltage. For example, when the accelerating potential is increased, the x-ray
frequency increases (wavelength decreases) and the penetration increases.
 Hard X-rays and Soft X-rays are distinguished by their frequencies. Hard X-rays have an
approximate wavelength of 0.01Nm while Soft X-rays have an approximate wavelength of
1Nm.
 Hard X-rays are preferred for imaging as they penetrate the body and are absorbed by
material such as bone, allowing images of the bone to be observed. Soft x-rays on the other
hand do not penetrate the body, meaning that they are not useful for imaging.

Explain how a computed axial tomography (CT) scan is produced

 Computerised axial tomography is a non invasive technique that uses x-rays to produce
images of various internal parts of the body such as the head, heart and abdomen.
 The production of a CT scan is as follows:
1. To produce a CT scan image, the patient likes on a table that is able to pass through a
circular scanning machine called a gantry.
2. A beam of X-rays is sent through the patient and detected on the other side of the
gantry. The degree of X-ray absorption (attenuation) depends on the tissue type that
it passes through. There are many detectors that make the circumference of the
gantry. The detectors measure the amount of x-rays that pass through the slice.
3. The beam is then rotated, usually in 1 degree increments and then another beam is
transmitted and detected. This process is repeated until an angle of 180 degrees has
been obtained or the final beam is emitted opposite to the initial beam fired.
4. The data from the scan is collected by a computer. The computer then uses the data
to reconstruct the image of the slice and can be displayed on a screen. In other words
the computer analyses the absorption of X-rays at each point of the slice to produce
an image.
5. A series of slices can be made to build a picture of an entire organ or even the whole
body

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  CT scan pictures are made up of many pixels with each given a grey scale value ranging from 1
(black) to 256 (white). CT scans are capable of producing high resolution anatomical images
 CT scans are used in an ever increasing range of diagnostic applications including the
detection of cancerous tumours, infections, bone fractures and even blood clots. Contrast
solutions such as iodine and barium sulphate can be added to improve contrast between the
scanned organ and surrounding tissue

Describe circumstances where a CT scan would be a superior diagnostic tool compared

to either X-rays or ultrasound

 CT scans are a superior diagnostic tool to ultrasound and X-rays when fine detail is needed.
This is the case when an image of the brain is required.
 CT scans take images from many different angles and can measure slight differences in
attenuation and therefore provide detail about the density of the bone and tissue. This makes
it possible to reconstruct a 3D image of a brain where all its features are shown such as its
bone structure, tissue.
 A construction of a 3D image is not possible with X-rays as X-rays only provide one angle and
further X-rays will only produce an image of the bone and not the tissue, since the bone
absorbs more X-rays then tissues.
 Similarly with ultrasound, imaging behind bone is not possible as the ultrasound signals are
reflected strongly from the tissue bone interface. This is due to their large differences in
acoustic impedance. Therefore ultrasound cannot provide information about tissue.
 CT scans produce images of much higher resolution then both ultrasound and X-rays.
Conventional x-rays have approximately 30 shades of grey while CT scans have 256 grey
scales. This allows better discrimination of the image meaning identification of the problem
area is easier to be seen. This also means that smaller problem areas can be identified such as
cancerous cells, blood vessel blockages.
 CT scans can measure slight differences in attenuation where X-rays cannot. This means that
CT scans can produce images of tissue while X-rays cannot. It also means that CT scans are
more sensitive allowing problem areas to be detected easier and with more reliability.
 A conventional X-ray shows an image of all the structures in the X-ray’s path. For example, a
radiograph of the lungs will also show the ribs. This presents difficulties for the doctor in
identifying problems in the lungs such as small tumours. CT scans on the other hand allow the
ribs to be ‘removed’ from the image.

Explain how an endoscope works in relation to total internal reflection

 Endoscopy is the medical examination of the interior of the body by inserting an endoscope,
through a small opening in the body. (either natural or as a result of an incision.)
 An endoscope is a device that uses light for looking inside the body to examine body organs,
cavities and joints.
 An endoscope functions on the principle of total internal reflection. An endoscope can
contain a bundle of optical fibres of up to 10 000. Each optical fibre is made out of glass core
with a cladding around it of a lower refractive index than the glass core. If the critical angle is
reached or exceeded by light striking the core-cladding interface, total internal reflection
occurs and the light is trapped. The light can travel along the core whether the core is bent or
straight.
 Endoscopes work because of the principle of total internal reflection. As a result endoscopes
can transmit light through the tube to illuminate internal areas of the body and then the
image of those areas can be carried back along the fibres of the endoscope to be observed by
the doctor.

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Discuss differences between the role of coherent and incoherent bundles of fibres in an
endoscope

 A coherent bundle is one in which the individual fibres are kept in the same relative positions
in the bundle at both ends. This means that coherent bundles are effective in transmitting the
image without any distortion as they are in the correct relative positions at both ends. The
image can be viewed via an eyepiece at the opposite end. The coherent bundles will create an
image of higher resolution if each individual fibre is as thin as possible.
 An incoherent bundle is one in which the individual fibres are not kept in the same relative
positions in the bundle at both ends. In other words the fibres are arranged in any order. As a
result they are used solely for lighting purposes, and are cheaper to make than coherent
bundles.
 Coherent bundles and incoherent bundles work in conjunction. Incoherent bundles provide
light to the area being examined while the coherent bundles transmit the image back to the
eyepiece for viewing.

Explain how an endoscope is used in:

 Observing internal organs
 Obtaining tissue samples of internal organs for further testing

Observing internal organs:

 The endoscope is inserted through a natural opening in the body or through a small incision. It
allows doctors to see inaccessible parts of the body and observe any problems inside the
body such as a tumour or pre-cancerous tumour. A fibre optic bundle (coherent bundle)
transmits an image that can be viewed on a screen.

Obtaining tissue samples of internal organs for further testing:

 Obtaining tissue samples is possible by inserting surgical attachments on the endoscope.
Some of the attachments include biopsy forceps (used to take a sample for further testing),
scissors and grasping forceps.
 For example if a tumour is detected, a small tissue sample may be taken for further analysis.
This is achieved by attaching biopsy forceps on the endoscope. Tumors may also be surgically
removed using an endoscope with other attachments.
 The procedure of using endoscopes is less invasive and carries less risk, allowing the patient
to cover more quickly as opposed to open surgery (which happened before the existence of
endoscopes).

Students:

Gather information to observe at least one image of a fracture

on an X-ray film and X-ray images of other body parts

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Gather secondary information to observe a CT scan image and compare the information
provided by CT scans to that provided by an X-ray image for the same body part

 Refer to dot point which discusses the superiority of CT as a diagnostic tool compared to X-
rays and ultrasound.

Perform a first hand investigation to demonstrate the transfer of light by optical fibres

Gather secondary information to observe internal organs from images produced by an

endoscope

Endoscope biopsy

3. Radioactivity can be used as a diagnostic tool

Outline properties of radioactive isotopes and their half lives that are used to obtain
scans of organs

 Radioactivity is the breakdown or decay of an element into a new element by the emission of
particles, alpha, beta or gamma. It measures function as opposed to X-rays which only show
structure.

Isotopes and radioactive isotopes:

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  The atoms of the same element with different numbers of neutrons are called the isotopes of
the element.
 All elements such as hydrogen have more than one isotope which either occurs naturally or
artificially.
 Sometimes the isotope is unstable and is then know as a radioactive isotope.
 Radio active isotopes are unstable and will decay or breakdown through the emission of
either alpha, beta or gamma particles from their nucleus. Sometimes a new radioactive
substance is produced and the decay continues until a stable isotope forms

Half life:
 Half life is the term referring to the time taken for half the radioactive isotope (or any
radioactive material) to decay.
 Not all radioactive isotopes decay at the same rate. For example Uranium has a half life of 4.5
x 10^9 years where as Polonium has a half life of only 1.5 x 10^-4 seconds.
 The half life of a radioisotope is important. For example if a radioisotope has a very long half-
life it can be dangerous for the patient as radiation is continued to be emitted after
measurements have been taken. On the other hand if the half life is too short, the
radioisotope either loses its useful radiation before measurements can be taken, or the
radioisotope emits radiation in a large dose which is harmful for the patient.
 Therefore a compromise needs to be taken. Radioisotopes with half lives ranging from several
minutes to days have sufficient time frames for medical diagnosis and of which is not harmful
to the patient.

 The table below shows the characteristics of the different types of radiation (alpha, beta, and
gamma) that can be emitted by radio active isotopes during its decay process towards a
stable isotope.

Types of Nature and charge Ionising effect Penetration level

radiation
Alpha Helium nucleus High Low
+ 2 positively charged (absorbed by a
sheet of paper
Beta Electron Medium Medium (absorbed
-1 negative charged by few mm of
tissue)
Gamma Electromagnetic Low High
radiation or wave (absorbed by many
0 no charge cm of tissue)

Describe how radioactive isotopes may be metabolized by the body to bind or

accumulate in the target organ

 Alpha particle emitting radioisotopes are not used in medical diagnosis because alpha
particles have high levels of ionization damage in the body and don’t travel far into the body
(low penetration)
 Beta particles travel further than alpha particles before they are absorbed but their ionization
damage is much less. They are used in therapy but not for medical diagnosis.
 The most useful radioisotopes for medical diagnosis are those that emit gamma radiation
only. This is because a gamma – emitting radioisotope have a high penetration level meaning
that the radioisotope inside the body can be detected outside the body via a gamma camera
as gamma radiation. Further gamma emitting radioisotopes have very low levels of ionization.
Examples of gamma emitting isotopes are Technetium -99m and iodine-123.

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How radioisotopes target the organ or region?
1. Radioisotopes target a specific organ by being chemically attached to a compound that would
normally be metabolized by the organ of interest. When this compound is chemically attached with
the radioisotope, it is called a radiopharmaceutical. For example, glucose is a compound that is readily
metabolized (absorbed) by the brain. Hence the radioisotope becomes attached to glucose to become
a radiopharmaceutical for imaging of the brain function.

2. The radiopharmaceutical is then injected into the bloodstream, inhaled or taken orally. Its passage
through the body is then traced by measuring the radiation it emits via a gamma camera. The
radiopharmaceutical than accumulates in the targeted area.

3. The gamma camera measures the amount of gamma radiation that is coming out of the patient’s
body and targeted area; this is then converted into an image. An image can be taken of up to a period
of several hours or a series of images can be taken over a period of time. In analyzing these images,
radiologists can identify ‘hot spots’ with a higher normal concentration of radioisotope and ‘cold
spots’ showing a lack of isotope and similarly and irregularities in the movement of the radioisotope .
These extremes often indicate areas of abnormalities or disease

Identify that, during decay of specific radioactive nuclei, positrons are given off

Discuss the interaction of electrons and positrons resulting in the production of gamma
rays

 Certain radioisotopes decay by the emission of positrons. Positrons are positively charged
beta particles or electrons.
 Positrons are formed when a proton breaks down or decays to form a neutron and a positron,
 Radioisotopes that are deficient in neutrons often decay in this way. For example, carbon-11
decays to boron-11, emitting a positron.
 When a positron meets an electron they ‘annihilate’ each other, in the process converting
their combined energy and mass into two gamma rays. The two gamma rays travel in
opposite direction with each gamma ray containing 0.51MeV of energy. This process is called
‘pair annihilation’.

Beta decay Pair annihilation

(In equation form)

Pair
annihilation (In visual form)

Describe how the positron emission tomography (PET) technique is used for diagnosis

 In PET (Positron emission Tomography), positron decay is used to determine the functioning
of the body. In particular, PET is used to produce images of brain activity and the metabolic
activity of other tissues; PET provides functional information. This is the main advantage of

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 PET over other imaging methods such as X-radiography, CT and MRI which show the structure
(anatomy) of the organ but not its’ functioning.
 PET has good diagnostic capabilities since diseases often alter the function of an organ or
tissue even before structural changes occur. PET is also used to measure brain activity related
to various tasks such as thinking, moving an arm, and can also detect heart disease and
cancer.

 The steps below are steps in which are taken for PET:

1. The patient is given positron-emitting radioisotope (through injection or inhalation) that is

chemically attached to a specific compound that an organ or specific region of interest
metabolises (absorbs). This is also known as a radiopharmaceutical. For example if the doctor
wants an image of a brain function, Carbon-11 will be labelled with carbon monoxide.
2. After a short period of time the radiopharmaceutical has accumulated in particular areas of
the body and begun to decay by the emission of positrons.
3. These positrons then encounter electrons in the body where ‘pair annihilation’ takes place.
Two gamma rays are produced and travel in opposite directions and emerge from the body
where they are detected by gamma cameras/detectors. Many pairs of gamma rays are
produced and detected and the information is fed to the computer.
4. The gamma rays are then analysed and the position of the decaying radioisotope can be
approximately determined.
5. An image is produced on a screen showing where the radioisotopes accumulate. It takes
about half a million gamma ray pairs to produce a useful image.
6. During a scan, the part of the patient being scanned is placed inside a gantry of gamma ray
detectors.

Students:

Perform an investigation to compare an image of bone scan with an X-ray image

 A bone scan reveals the way in which the organ functions by take up of the radioisotope
(gamma emitter.) It is best for whole body scans, where hot spots can be seen clearly.
 Bone scans can detect tumours 3-6 months earlier than x-rays, as they are much more
conclusive and sensitive. For example, stress fractures, which gather blood and the Tc99m,
show in bone scans but may not appear in x-rays. They can also detect early bone disease.

Bone Scan X-Ray

Uses: Radioisotope (Tc99m) Electromagnetic Radiation
Method of detection: Gamma Camera Photographic Film
Identifies: Function problems Structural Problems
Clarity: Fuzzy (gamma radiation) Clearer – one source of travel

Gather and process secondary information to compare a scanned image of at least one
healthy body part or organ with a scanned image of its diseased counterpart

Red = Healthy and working

Blue = Area has already died

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PET scan of a brain
4. The magnetic field produced by nuclear particles can be used as a diagnostic tool

Identify that the nuclei of certain atoms and molecules behave as small magnets

 As the nucleus is rotating, the nucleons (protons and neutrons) circle around the axis of the
nucleus and produce a magnetic field. The nucleons also spin on their own axis (spin angular
momentum) to produce its own magnetic field while orbiting the rotating nucleus. This
phenomenon is related to the spin of the protons and neutrons. The combined effect of all
these magnetic fields results in the nucleus acting like a tiny magnet.

Identify that protons and neutrons in the nucleus have properties of spin and describe
how net spin is obtained

 Spin is a measure of the intrinsic angular momentum of an elementary particle such as a

proton, electron and neutron. We all know that when a body of mass m travels in a straight
line with velocity v it has a linear momentum given by: p=mv. Similarly a body of mass m
moving in a circle of radius r with a speed v has angular momentum given by: L = p x r.
 Spin like mass and charge is a fundamental property of all elementary particles such as
protons and neutrons. It comes in multiples of ½ and can be (+1/2) spin up or (-1/2) spin down.
 Protons and neutrons in the nucleus have a property referred to as ‘spin’. In other words the
nucleons (protons and neutrons) are spinning on its own axis which is spin angular
momentum. However at the same time, the particles are orbiting the nucleus which gives the
nucleons orbital angular momentum. The ‘spin’ is just the spin angular momentum while the
nucleons orbiting the nucleus are called orbital angular momentum. Therefore the total
angular momentum of a nucleus is the sum of both spin angular momentum and orbital
angular momentum.
 A simple analogy that illustrates the information above is to imagine the earth spinning on its
own axis which is spin (spin angular momentum) while also orbiting the sun at the same
time.
 Protons and neutrons pair up, with protons pairing with protons only and neutrons pairing
with neutrons. Each pair has one particle which is spinning up (+) and the other spinning
down (-), thus the net spin is zero. Each unpaired neutron or proton contributes to (1/2) to the
net spin of the nucleus.
 The general rule is as follows concerning spin:
o If the mass number is odd in other words there
are unpaired protons/neutrons, the net spin of
the nucleus is in multiples of ½, 3/2, 5/2 etc…
o If the mass number is even but the atomic
number is odd, then net spin of the nucleus is a
whole number.
o If both the mass number and atomic number are
even, the net spin of the nucleus is zero.

Explain that the behaviour of nuclei with a net spin,

particularly hydrogen, is related to the magnetic field
they produce

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  Nuclei that contain charged particle with a net spin other than zero produces a magnetic field
and therefore acts like a tiny magnet with a north and south pole.
 The hydrogen proton in particular where the net spin is ½ has two energy states which are -1/2
(spin down) and +1/2 (spin up). The net spin is ½ because there is one pair of protons and an
unpaired proton with a +1/2 (spin up).
 Therefore the hydrogen protons produce magnetic fields in opposite directions cancelling
each other out with the exception of the unpaired electron producing the net spin.
 Hydrogen is used because of its abundance in the human body, being the major constituent of
water as well as organic molecules, such as glucose. Further the proton in the hydrogen atom
has the largest magnetic moment for its spin, providing the strongest resonance signals.
 Groups of particles also have a spin as a result of the spin of their individual particles. A
nucleus, for example, has a spin determined by the spin of the nucleons that make it up. (The
nuclear spin is the sum of the orbital angular momentum and the intrinsic angular spin of the
nucleons.)

Describe the changes that occur in the orientation of the magnetic axis of nuclei before
and after the application of a strong magnetic field

 Before the application of a strong magnetic field, the magnetic fields in protons in hydrogen
atoms will be randomly orientated until and external strong magnetic field is applied. Further
before the application of the magnetic field the two orientations of spin up and spin down
have the same energy level.
 However in the presence of a strong external magnetic field, the hydrogen atoms try to align
themselves either parallel (spin up – lower energy state) or antiparallel (spin down, higher
energy state) to the external magnetic field. This is also the case when a bar magnet is placed
in a stronger external magnetic field, it attempts to align itself with that field. This is the
phenomenon on which a magnetic compass relies for its operation.
 A slight excess (about 9 in every two million) of protons align themselves parallel with the
external magnetic field.
 The stronger the external magnetic field, the greater the energy level difference between the
two states and the more hydrogen atoms are aligned with the field.

Define precessing and relate the frequency of the precessing to the composition of the
nuclei and the strength of the applied external magnetic field

 When the nuclei with a net spin charge change their orientation in response to the external
magnetic field, they do not remain in a steady position along the external magnetic field, but
rather precess around the direction of the magnetic field.
 Precession is the rotation of a body about a second axis when also rotating about its own axis
of symmetry. An example is a spinning top which spins on its own axis while spinning around
another.
 The frequency at which the protons of the hydrogen atom precess (larmor frequency) is
related to both the composition of the nucleus and the strength of the external magnetic
field.
 That is different nuclei due to their composition have different precession frequencies for a
specific magnetic field strength. This is shown in the table below.

Nucleus Larmor Frequency in a 1.0T B field (Mhz)

Hydrogen-1 42.57
Carbon-13 10.70

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  It follows that the Larmor/precession frequency is directly proportional to the strength of the
external magnetic field. For example the Larmor frequency for hydrogen protons is 42.57 x B
field. If the external magnetic field is 1T, the larmor frequency is 42.57Mhz.
 The uniqueness of the larmor/ precession frequency of specific atomic nuclei enables the MRI
to identify and distinguish between different body tissues as they have different chemical
make ups, therefore giving off different larmor frequencies.

Discuss the effect of subjecting precessing nuclei to pulses of radio waves

 With the patient in the strong magnetic field, so that the protons in the hydrogen atoms are
precessing around the direction of the external magnetic field, a pulse of radio frequency
electromagnetic radiation is beamed into the patient. The frequency is chosen to correspond
exactly with the Larmor frequency. As a result the protons will resonate (absorb) with the
radio frequency, absorbing its energy and move into a higher energy level and precess in
phase with one another.
 In simple terms, the emission of radio frequency that is equal to the larmor frequency of the
nucleus, resonance occurs, causing the spin to flip from low energy level (parallel to B field) to
high energy level (anti parallel to B field).
 The net effect is that all the protons from the hydrogen atom are spinning in phase in the
same direction, anti parallel to the magnetic field, spin down.

Explain that the amplitude of the signal given out when precessing nuclei relax is related
to the number of nuclei present

 When the radio frequency pulse is stopped, the protons of the hydrogen atoms will (relax)
return to their original state, that is the low energy level which is parallel to the magnetic
field.
 In the process of relaxation , the protons will release the energy they gained from the radio
frequency pulse as weak radio signals as the same frequency as the incident wave (the larmor
frequency). This can be detected and converted into a signal representing the corresponding
Larmor frequency.
 The amplitude or intensity of the signal given out by the relaxing protons will be dependent
on the amount of relaxing hydrogen nuclei in that particular region (proton density). For
example the signal with highest intensity will be emitted out from fluids as it has the greatest
concentration of hydrogen atoms. The next is soft tissue, followed by cartilage and
membranes. Bones show no MRI signal, meaning they are not represented on the MRI image,
which can be considered as a disadvantage of MRI.

Explain that large differences would occur in the relaxation time between tissue
containing hydrogen-bound water molecules and tissues containing other molecules

 Large differences in relaxation time occur between different tissue types due to the amount
of hydrogen atoms in a particular area (proton density). For example tissue containing more
water molecules, hence more hydrogen atoms will have a longer relaxation time than a tissue
containing less water. The reasons is since there are more hydrogen atoms, it takes longer for
all the hydrogen atoms to relax then a tissue with less hydrogen atoms.
 The MRI scanner can then produce a proton density map of the body which is then converted
into an image.

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Students:

Perform an investigation to observe images from magnetic resonance image (MRI)

scans, including a comparison of healthy and damaged tissue

Brain Tumour Healthy Brain

Identify data sources, gather, process and present information using available evidence
to explain why MRI scans can be used to:
- Detect cancerous tissues
- Identify areas of high blood flow
- Distinguish between grey and white matter in the brain

 MRI is considered to be the best diagnostic imaging technique for structural resolution and
contrast.
 It is useful for imaging areas with large amounts of water as theses areas have many
hydrogen nuclei. As a result MRI is useful for detecting cancerous tissues.
 Cancerous tumours/tissues contain different amounts of water from normal tissue or are
surrounded by watery tissue which can be seen in an MRI scan because of the different
brightness due to the different proton density of the cancerous tissue.
 Similarly MRI can detect areas of high blood flow because blood contains water which
contains hydrogen atoms. This can be distinguished on an MRI scan as the areas of high blood
flow appear brighter then areas of normal blood flow due to the higher (hydrogen) proton
density. Similarly MRI can detect areas of low blood flow, which could diagnose clogged
arteries.
 Grey matter in the brain and spinal cord contains more water than in white matter, thus they
can be distinguished in an MRI scan which is useful in diagnosing multiple sclerosis.

Gather and process secondary information to identify the function of the

electromagnet, radio frequency oscillator, radio receiver and computer in MRI
equipment

 Electromagnet: The patient is placed in a strong magnetic field of 1.5T, which cause the
hydrogen protons within the body to align with the magnetic field and then precess around
the external magnetic field lines.

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  Radio Frequency oscillator: The radio frequency oscillator bombards the patient with pulses
of radio waves with a frequency matching the precession/lamor frequency of the hydrogen
atom. As a result resonance occurs causing hydrogen of low energy state (parallel to
magnetic field) to jump up to a high energy state (anti-parallel to magnetic field) as it absorbs
the radio waves energy.
 Radio receiver: When the radio pulses are switched off, the hydrogen protons relax and return
to their original state, in the process releasing the energy which they gained in the form of
radio waves at the same frequency in which they received (larmor frequency). This is detected
by the radio receiver
 Computer: A computer is used to decode the signals into a visual image. This is done by
analyzing the relaxation time (the duration of the radio signal which depends on the amount
of hydrogen atoms in the tissue) and the intensity of the signal which also depends on the
proton density.

Gather, analyse information and use available evidence to assess the impact of medical
applications of physics on society.

 The advancement of other fields such as the understanding of the electromagnetic spectrum
and sound properties has equipped medical practioners with sophisticated tools to diagnose
diseases. This has allowed more diseases then ever before to be diagnosed, meaning that
preventative measures can be taken rather than curative measures, leading humans today to
live longer then ever before.
 The advancement of medical technology has also expanded the knowledge of the human
body, of how it works. For example the development of the PET scan has allowed brain
activity to be examined closely through everyday activities such as thinking, walking. This has
allowed increased understanding of the brain which previously very little was known about.
Further brain related diseases can be diagnosed such as multiple sclerosis and similarly the
effects of theses diseases can be seen such as dementia.
 Further the advancement of medical technology has allowed medical examinations to be
quick, painless for the patient. It has also developed non-invasive techniques such as X-rays, Ct
scan, MRI, improving efficiency and time. The development of key hole surgery via endoscope
has made the use of open surgery only when necessary, as opposed before these medical
advancements, open surgery was frequently used to diagnose and treat diseases.
 It has allowed the standard of living to increase, as humans are healthier and living longer. As
a result population levels are maintained and increased as less medical advancements have
attributed fewer deaths.
 The development of X-rays is particularly important for the sporting world. The use of quick,
simple X-rays can diagnose fractures in a short period of time. Further it is widely accessible to
the general population; again this increases the standard of living and quality of life.
 The development of ultrasound has allowed the diagnosis of babies. This means that
preventative measures can be taken if the babies have a problem. Early childhood problems
can be detected, and prior arrangements to treat any disorders can be done much earlier,
removing problems that would happen at birth.
 In conclusion medical advancements are an intrinsic part of everyday life. Medical
advancements have provides doctors additional tools to diagnose diseases, which is painless,
quick and non-invasive. This has improved efficiency, accuracy and the standard of living and
quality of life.

Identify data sources, gather and process information to compare the advantages and
disadvantages of X-rays, CT scans, PET scans and MRI scans

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Imaging Procedure Advantages Disadvantages
Technique
X-rays - A beam of X-rays is directed - Least expensive - Shows structure but
through the patient. Bone and - Very fast time for not the function of the
different tissue types allow the X- examination organ
rays to pass through varying - Gives very good - Shows all structures,
degrees. resolution for bones, for example, the ribs
- An image is formed on a therefore commonly over the lungs making
photographic plate as a series of used for bone it more difficult to
shadows. fractures. diagnose lung diseases.
- On radiograms, bones show up as - Resolution not as
white against a darker background. good as MRI
Bones show up as white because - Ionising radiation
they absorb more X-rays then soft used and so exposure
tissue. must be accurately
controlled.
- Often the patient may
have to fast before the
X-ray or be required to
take special substances
such as ‘barium meal’
CT scans
- From gantry, a series of X-rays - Resolution much - Shows structure but
beams is directed through the better than not the function of the
patient from one degree conventional X-rays, organ.
increments and is detected on the meaning diagonising - Ionising radiation
other side. diseases is easier. used and so exposure
- Computers take the information - Creates a cross- must be accurately
and build up a picture of a slice of sectional image of the controlled.
the particular organ which can be viewed organ - More expensive than
displayed on a TV screen or on a - Three dimensional conventional X-rays.
photographic plate. images can be
generated.
- Good for diagnosing
tumours.
PET scans
- A radiopharmaceutical (radio - Provides the function - Ionising radiation
isotope attached with a chemical of the organ just not its used and so exposure
compound) is injected or inhaled structure. must be accurately
by the patient. - Good for diagnosing controlled.
- The radioisotope emits positrons stroke and other - Expensive to use (a
which annihilate with electrons in neurological diseases. cyclotron must be
the patient and emit gamma rays. nearby to provide the
- A special camera detects these short life of the
gamma emissions. radioisotope)

MRI scans
- The patient is placed in a strong - No ionising radiation - Most expensive
magnetic field which aligns the is used (that is X-rays or imaging technique. The
hydrogen protons in the patient’s radioactive emissions). machine itself costs 1M
body in the direction of the - Provides the highest dollars.
magnetic field. resolution of tissues - Some people
- Pulses of radio frequency that is and organs such as the experience
matched with the larmor brain. claustrophobia from
frequency of the hydrogen atom is - It can emphasise the small area they

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emitted from the radio oscillator specific areas of the have to lie inside.
into the patient, resulting in organ by using T1 ot T2 - MRI requires a long
resonance, The pulses are turned weighted. scanning time of 40
off, where the hydrogen protons - With FMRI it can minutes compared to 5
emit the energy. provide both structural minutes for a CT scan.
- A computer decodes this and functional views of This increases
information and an image (2D or the brain. operating costs, and is
3D) is produced. less flexible in terms of
time for the patient.
- People with
pacemakers or metal
prothesis cannot be
scanned due to
powerful magnetic
field.

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