Radiology Research Group

Nuffield Department of Surgery

MSc in Diagnostic Imaging

Course Manual

Course Director: Dr. S.J. Golding

MSc in Diagnostic Imaging

University of Oxford

Manual for the MSc in Diagnostic Imaging

Contents

Section 1

Overview of objectives

Section 2

Specification of core syllabus

Section 3

Teaching on the MSc Course

Section 4

Producing the dissertation

Section 5

Assessment

Section 6

Where to go in case of problems

Section 7

People and contacts

Annex plagiarism

Academic integrity: good practice in citation, and the avoidance of

Contents last reviewed: October 2008

MSc in Diagnostic Imaging

University of Oxford

Section 1 Overview of Objectives

These notes are provided for the general guidance of students and should be read in conjunction with the Universitys Decrees and Regulations and the Notes for the Guidance of Graduate Students published by the Medical Sciences Division. This overview and the notes in the following sections are intending to help you prepare for and carry out your work on the course. The course is run by the Radiology Group of the Nuffield Department of Surgery, within the Medical Sciences Division. Dr Stephen Golding is the Course Director and there is an Organising Committee which is responsible under the Department for the management of the course, members representing Radiology, Radiography and Medical Physics. You will be taking this course either full-time over one year (ending July 2009), or part-time over two years (ending July 20010). Whichever route you take, the work required to obtain a Masters degree is significant and it is important that you organise your work to proceed regularly throughout the time of your course. The main objective of this course is to give you the knowledge and skills to acquire a degree to aid your career development. You will also acquire skills in post-graduate study and possible also research method, as described in the later sections of these notes. The structure of this course is the core and options model (Section 2). The core syllabus consists of essential basic science in diagnostic imaging, a good knowledge of which is expected of all students. The options are provided to allow you to explore the subject further in a manner appropriate to your background and interests, whether you are qualified in medical or nonmedical subjects. The lecture course you take is intended to cover the core syllabus (Section 3). You attend these lectures in the company of hospital staff who are training to be radiologists. They have further subjects to study and other forms of training to undertake but you will find it useful to work as closely with them as you are able. In addition seminars on skills specific to the course are provided regularly. A list if provided in Section 3. A key element of your support is your supervisor. You will have been allocated a provisional supervisor for the start of the course but alternatives may be chosen after exploration of your interests. You are expected to meet regularly with your supervisor throughout the course. A key element of your work is your project dissertation (Section 4). One of the most important roles of your supervisor is to help you to choose a suitable project and carry it out effectively. As part of your assessment on the course you are required to produce a written assignment by the end of each of the first two terms (or second and fourth terms for part-time candidates) (Section 5). These are chosen and planned after discussion with your supervisor.

Advice on reading material and other learning and support resources is given in the later sections on this manual. However you should feel free to consult your supervisor and tutors on these aspects at any time and considerable further advice is available if you need (Sections 6 and 7). Similarly, we will asking you for your views on the course regularly as the course proceeds but you should also feel able to comment on the course to your supervisor or tutors, and to raise any concerns you have with them.

Your objectives for the first few weeks of the course are: 1. 2. 3. 4. To develop your plan for studying, around the lectures. To choose a subject for and plan your first terms written assignment. To discuss with your supervisor a suitable project for your dissertation. To identify any particular learning needs you feel you may have, having studied the information about the course.

S.J.Golding, October 2008

MSc in Diagnostic Imaging

University of Oxford

Section 2 Specification of Core Syllabus

These guidance notes are intended to be read in conjunction with the Schedule for papers 1,2 and 3, contained in the Regulations. This paper sets out the parts of the syllabus which form the essential core of your learning for the MSc, and which will be required of all candidates. These subjects are specifically examined in part A of the written examination papers but are also relevant to the rest of your learning on the course, including your preparation for part B of the examination papers. Overall, the core syllabus represents around half of the total Schedule. Many of the subjects are extracted unchanged from the Schedule. Others are listed in the Schedule but their core elements are limited to principles of these subjects. Those candidates pursuing a technical approach to this degree should note that they will need to acquire deeper knowledge of these subjects, as indicated in the Schedule. Candidates pursuing clinical interests on the course may instead concentrate on the clinical elements in the Schedule once the core syllabus has been acquired.

Note that although the core and options structure allows candidates to deepen their knowledge in areas of the syllabus which are appropriate to their background and interest, all candidates are expected to have a basic knowledge of all subjects listed in the syllabus. The optional element of the course is the matter of putting emphasis on aspects relevant to the candidate. It does not mean that the other parts of the optional syllabus can be ignored.

Candidates will note that while clinical applications of all techniques are not specifically listed as core syllabus, all candidates will be expected to acquire an overview of how techniques are used in the examinations of each body system, most particularly how techniques relate to each other in clinical practice.

Attachments: Specification of Core Syllabus Extract from Decrees and Regulations, covering the complete syllabus.

Core Syllabus Paper 1: X-rays, Radiological Procedures and Radiography Atomic and nuclear physics, ionising radiation and interactions with matter. Production of x-rays, formation of radiographic images, principles of design of equipment for generating x-rays. Principles of measurement of quantity and quality of ionising radiation. Imaging receptors: photographic film, intensifying screens, fluoroscopy, image intensification and television systems. Principles of radiological contrast media: general indications, contraindications and complications. General principles of radiological contrast media examinations, including angiography. Advantages and disadvantages of these techniques. Principles of radiological protection and basic methods of protecting patient. Principles of positioning and standard radiographic projections. General principles of microradiology, macroradiography and soft tissue radiography. High voltage techniques and influence of exposure factors.

Paper 2: Nuclear Medicine and Ultrasonography Radioactivity and radioactive sources. Radiation detectors and scintigraphic equipment. Measurement of radio-activity. Gamma-ray spectroscopy. Radioisotope generators and principles of radiopharmaceuticals. Imaging devices; static and dynamic imaging. Emission tomography. Biological distribution of radionuclides. Production, nature, propagation and detection of ultrasound. Imaging methods and data display. Doppler effect and flow-sensitive imaging. Safety of ultrasound. Tissue characterisation by ultrasonography. Principles of ultrasound contrast agents. Advantages and disadvantages of ultrasonography. Paper 3: Computed Tomography and Magnetic resonance Imaging Design of computed tomographic equipment; production of x-rays, detection, data collection, image reconstruction and display, helical and multislice technology. Characteristics of CT images: matrix, pixels, voxels. Principles of radiation dosimetry in CT and patient protection. Principles of contrast media used in computer tomography. Advantages and disadvantages of computed tomography. Physical principles of magnetic resonance. Equipment design, magnets and coils. Images production and array processing. Characteristics of magnetic resonance images: matrix, pixels, voxels, image contrast considerations. Effects of flow and principles of flow-related imaging. Hazards of magnetic fields and patient protection. Advantages and disadvantages of both techniques in practice.

(Core syllabus approved by Organising Committee 2003)

MSc in Diagnostic Imaging Section 3

University of Oxford

Teaching on the MSc Course

Your learning on the course is supported by a series of lectures which cover the core syllabus. This is intended to form a framework around which you will organise your reading and learning. As the course represents a core and option structure, it is not possible to provide a formal teaching course for the subjects you choose from the rest of the syllabus to study in depth. You should therefore expect to carry out a large amount of private study and reading, under the guidance of your supervisor, to fulfil the requirements for your degree.

Teaching for the core syllabus

A course in the physics of diagnostic imaging is given by the department of Medical Physics, in partnership with the NHS Department of Radiology. This lecture course is held in the teaching room in the MRI Centre at the John Radcliffe Hospital (unless stated otherwise) and is held in your first (Michaelmas) and second (Hilary) terms. In Michaelmas the course takes place on Wednesday morning and afternoon and covers the principles of radiation and its use in imaging. In Hilary Term the course is held in the mornings only and is dedicated to modern imaging techniques. The trainee radiologists who will share the course with you also have to study clinical radiology and their lecture programme is more extensive, with clinical lectures added at the end of the Wednesday lecture series. This clinical part of the course is not part of your syllabus but some of these lectures may be appropriate to you (for example for your dissertation project or assignments) and you may be allowed to attend these lectures if you wish. It is advisable to check with your supervisor or the tutor before doing so. It is important to realise that the lecture course is intended to give you a framework for your own learning. You should expect to read extensively around the subjects being taught and you will probably extract most value from the lecture course if you do some reading about each topic before you attend the lecture.

Attachments: Lecture Schedule

B. Group Seminars
There will be a small number of seminars examining specific aspects of your learning, including an overview of the course, preparation of your dissertation and preparation for the written examination. You will be notified of these seminars well in advance. a. b. c. d. Introduction to the Course and Objectives Constructing a dissertation (with guidance notes) Review of dissertation projects Preparing for the degree examination

C. Private study
As indicated above, you are expected to carry out a large amount of private study, under the guidance of your supervisor and your tutors. The educational resources available to you are described below and a suggested reading list is attached. Attachment: Reading List

There are excellent bookshops in Oxford and you may find it valuable to browse their stock with the Reading List in mind, to identify the books that you feel will help you most. When studying privately, it is sometimes difficult to form an accurate idea of the depth to which you should be learning. This is a question that you should take the opportunity of exploring with your supervisor at your regular meeting with him or her.

D. Other learning resources

D1. Libraries The Barclay-Kemp Library in the MRI Centre is a fine collection of radiological journals and you are encouraged to use this facility as much as possible. Journals may not be taken away but you may use the department photocopier to copy any important papers for your own private study, providing you bring your own supply of paper. The main x-ray department reading room (Level 2) has a reasonable collection of radiology textbooks which are available for private study. Only short loans are permitted and the books are in heavy demand by people training in clinical radiology. It is anticipated that you may wish to buy your own copies of the key textbooks for the course. The Cairns Library, on Level 3 in the Academic Centre at the John Radcliffe Hospital, is an extensive medical library, which allows 24 hour loans. You may apply for membership of the library as soon as you are issued with your hospital security pass. Your college will also have a library. This may not contain much material on diagnostic imaging, as this is a small subject in the University. However many colleges are willing to acquire books suggested by graduate students which are needed for their course. You should discuss this with your College Librarian in the first instance.

Oxford University has, in the Bodleian and Radcliffe Science Libraries, among the most important written collections in any university. You have access to these collections when your college has issued your university identification card. D2. Other resources You will almost certainly find that your college provides good facilities for wordprocessing and basic computing. Your college will also organise an e-mail account for you. However students frequently find it convenient to have their own personal computer for private work. The University provides specific courses in computing and other subjects such as scientific use of language. Details are regularly advertised in University and college notices and you should also look at the information provided by the notes on Skills and Training, included in the Notes for the Guidance of Graduate Students of the Medical Sciences Division (if you are not distributed with a copy of this it can be obtained from the Medical School Office on Level 3 of the Academic Centre at the John Radcliffe Hospital. If you feel you have any particular learning needs or difficulties in resources you should discuss these with your supervisor in the first instance. E. The role of the supervisor The supervisor represents one of the most important resources supporting your learning on the course. You should aim to meet regularly with your supervisor throughout the course, at the very least every two weeks, and more frequently if necessary. The supervisor is responsible for ensuring the progress of your work, and for providing advice on reading and study, and where to find information. They will also advise you on the choice and structure of your term written assignments. Their most important task is to help you choose, plan and carry out your dissertation. Your supervisor is initially allocated to you by the Graduate Studies Office on a provisional basis. Your provisional supervisor will either be confirmed with you after initial discussions or you maybe allocated to an alternative supervisor. This is most likely to happen if you undertake the dissertation project in collaboration with another member of staff. Sometimes the role of supervisor is shared jointly between your originally allocated supervisor and the person helping with your dissertation. Your supervisor will usually extend their activity to include making sure that you are generally happy with your post-graduate life. You should therefore feel that you should seek advice from your supervisor or anything that impinges on your work. Your supervisor is required to submit a formal report of your progress to the Graduate Studies Office each term. This may or may not be discussed with you at the time but is circulated to your College and may be taken up with you by the Graduates Officer of your College. You should remember that most supervisors are busy people. While most of them will make every effort to be fully available to you, the requirements of their own professional lives may mean that this is sometimes difficult. In particular, you should

not expect to call on your supervisor for a great deal of work or support at short notice, accept in unusual conditions. You will generally get the best support from your supervisor if you plan to see them regularly and give them good advance notice of your needs and requirements. F. Other support Members of the Radiology Group, which is based in the MRI Centre, may be able to help you with specific needs, for example while preparing the dissertation, according to subject. Your superviser will be able to advise and arrange contact for you. The academic radiographer in the group acts as the group manager and will usually be on hand for help as you need. Your will be appointed a College Advisor, who will also aim to help you with your work on the course and give you advice if you need it. In addition, you may from time to time call on the administration at the Medical School, the Departments Graduate Studies representative, or the central University Graduate Studies Office. More information is provided in Sections 6 and 7 of the manual indicating where to go in case of problems.

MSc Course in Diagnostic Imaging Reading List

University of Oxford

The books described below are intended as a general guide to reading. Choosing and using and textbook is often a personal matter and where possible you should aim to have a look at the available textbooks before considering buying any for your own use. Books have been listed to cover the entire syllabus for the MSc. You will not need to use all of these, depending on whether you are following a scientific approach or a clinical one. Further recommendations will be made as the course proceeds. You may also find it helpful to discuss with the FRCR Part I candidates the reading material that they have found useful. Imaging textbooks tend to be expensive on account of the large number of images. Where possible editions in paperback have been recommended and the prices given are intended as a general guide only. As these books will be intensively used throughout the course, you will probably find it difficult to get copies from libraries and you will have to consider purchasing at least some of the books. Used copies are frequently available and it is worthwhile searching booksellers like Amazon on the Internet, or looking regularly at the website of the Society of Radiologists in training (www.thesrt.org.uk). Introductory reading You may not need to do any introductory reading for this course but if you prefer to start with this approach, do not let it get in the way of beginning your reading for the core syllabus (see below). However if you would like to get an overview of the subject at the outset you might like to have a look at: Fundamental Aspects of Radiology: a revision guide for the Part I FRCR. I S Francis, R I Aviv, E A Dick, A F Watkinson. Remedica, 1999. (paperback, 28) This is a useful overview of all aspects of basic science in diagnostic imaging. Reading for the Core Syllabus The Essential Physics of Medical Imaging (2nd Edition) J T Bushberg, J A Seibert, E M Leidholdt, J M Boone, Lippincott, 2000 (hardback, 75) A large textbook, which includes all the core syllabus and will also supply scientific candidates with much of the essential information for the rest of the syllabus. Overall, it is probably the best book for this course. It is however expensive. You may be able to find a used copy. The previous edition of 1994 is also still adequate for the course. Physics for Diagnostic Radiology. (2nd edition) P P Dendy, B Heaton. Institute of Physics, 1999 (paperback, 30). This is a good small alternative to Bushberg et al and would also make a good introduction to the core syllabus. If you choose to use this book for the whole course you will need to supplement it by reading elsewhere. Overview of Radiology

Diagnostic Imaging. (5th edition) P Armstrong a & M L Wastie. Blackwell Science, 2004 (paperback, 48). Armstrong and Wastie is ostensibly intended for medical students but goes further than this and offers a good basic overview of diagnostic imaging for MSc candidates who want to follow a clinical approach to their degree. It would need supplementing by a little further reading around imaging techniques. A Concise Textbook of Radiology. P Armstrong & M L Wastie. Arnold, 2001 (hardback, 99). Armstrong and Wasties larger volume is a comprehensive textbook for trainees in diagnostic radiology. It would be useful as a reference book for the MSc course but contains much more information than the course requires. Diagnostic Radiology: a Textbook of Medical Imaging. 5th edition R G Grainger, D J Allison, A Adam, A K Dixon. Churchill Livingstone, 2007 (hardback 300). It is not suggested you buy this book! This is the standard bible of diagnostic imaging, representing state of the art approach to the subject. Each section has a technical introduction covering the science behind the subject, and then comprehensive descriptions of clinical imaging. This book is available in most department libraries and you will find it a useful reference book for studying particular aspects in detail. Radiography Basic Radiographic Positioning and Anatomy. G Bell, D Finlay. Elsevier, 1986 (paperback, 25). The amount of radiography required by the course may not justify you acquiring a specific book for the purpose, although you will need to find sources of information to support the syllabus. If you want to have a specific book for Radiography this is one of the best. Radiological Anatomy Candidates following a clinical approach to the degree will need to do some reading on radiological anatomy to support their learning of clinical techniques and their uses. This subject is not very well represented in the literature and it will be necessary to look at several texts but those below offer an overview. Imaging Atlas of Human Anatomy. J Weir, P H Abrahams. Mosby, 2003 (paperback, 40). This is a good basic overview of the anatomy essential to diagnostic imaging. It would make a good basic book for anyone following a clinical approach to the MSc. Anatomy for Diagnostic Imaging. S Ryan, McNichols, Eust. Saunders, 2003 (paperback, 40). This book is due for publication in December 2003 but offers a one volume survey of human anatomy related to the significant features which are seen in imaging. A warning: reviews have noted misprints and errors in the text. Applied Radiological Anatomy. P Butler, A W Mitchell, H Ellis. Cambridge University Press, 2007 (paperback, 30). This is an excellent reference book covering most of the anatomy required to support knowledge of clinical imaging. Contains much more than the MSc Course requires. Pocket Atlas of Radiographic Anatomy. E Reif, T B Moeller. Thieme Medical Publishers, 2000 (paperback, 24).

A rather basic book outlining essential points of anatomy on conventional radiographs. Textbooks on Specific Imaging Techniques These will be useful as reference texts for those following a clinical approach to the MSc and individual volumes will be helpful to those carrying out a project in one of the technique areas. Overview of radiological techniques: A Guide to Radiological Procedures. S Chapman, R Nakielny, Saunders, 2001 (paperback, 30). Computed Tomography: Fundamentals of Body CT. W R Webb, W E Brant, C A Helms. Saunders, 2005 (paperback 45). Ultrasound: Diagnostic Ultrasound: principles and instruments. P.Hoskins, A Thrush, K Martin, T Whittingham. GMM 2002 (paperback, 35). Magnetic Resonance Imaging: MRI at a Glance. C Westbrook. Blackwell Science, 2002 (paperback, 20). MRI in Practice. C Westbrook. Blackwell Science, 2005 (paperback, 30). MRI: the basics. R Hashemi, W G Bradley. Lippincott, 2003 (paperback, 30). Nuclear Medicine: Essentials of Nuclear Medicine Imaging. F A Mettler, M J Guibertau. Saunders, 2005 (hardback, 65). Nuclear Medicine: the requisites. J H Thrall, H A Zeissman. Mosby, 2006 (hardback, 65). General Guidance Writing your Dissertation in 15 Minutes a Day. J Bolker. Henry Holt, 1998 (paperback, 12). A useful small paperback that gives a lot of good advice on dissertation construction, as well as a practical plan for making this exercise painless!

MSc in Diagnostic Imaging

University of Oxford

Section 4 Producing the Dissertation

The dissertation represents a major part of your work on the course, contributing 50% of the examination marks towards your degree. It is therefore important that you put significant effort into producing the dissertation, as you can work on it steadily throughout the course and it makes the largest contribution to your examination marks. The objective of the dissertation is to demonstrate that you have learnt how to obtain, analyse and manage scientific information and build this into a significant project. For the purpose of this degree, you are not expected to make an original contribution to scientific knowledge but must demonstrate that you can use scientific and academic method, including extracting essential information from the published literature. Your dissertation must be up to 15,000 words in length and must be constructed and presented in an appropriate manner. A group seminar will be held on dissertation design. The content of the dissertation may either result from a review of the literature, or from writing up a clinical or research project. Generally speaking, projects are easier to write than literature reviews and you may therefore consider finding a suitable project if you can, with the advice and guidance of your supervisor. It is important to find a project that coincides with your interest, as you will be putting a lot of effort into carrying it out. Whether you choose to do a literature review or a project report, either must be based on scientific method. In other words, you must generate a hypothesis and test it, either by experimental method or by analysis of the published literature. Your dissertation should form a coherent argument. Reproducing large sections of already published work would not be regarded as an acceptable approach. Your supervisor will help in your choice of project and how to plan it. As indicated above, if your project involves another member of the department they may become your supervisor if this seems appropriate. The immediate task after choosing a subject for your dissertation is to write a specification, or plan, for how you intend to carry it out. You do this in conjunction with your supervisor. Attachment; example project specification.

Key Facts:

Your dissertation will be: a research/clinical project or literature review an identification of your ability to handle scientific method well presented, printed and bound no longer than 15,000 words submitted for your examination up to 50% of the marks available for your degree

MSc in Diagnostic Imaging

Example of Project Specification

Draft Title: Can MRI replace radiography in the evaluation of dental disease?

Rationale:

MRI has been shown to be more sensitive than CT, which is more sensitive than radiography in the evaluation if intraosseous disease such as metastases. The present project extends this finding to dental examination. Conventional investigation of dental root and mandibular pathology is by radiography but it is recognised that disease detection by radiology occurs late in the course of the problem. It is postulated that MRI can detect intramandibular and dental root pathology at an earlier stage. Moreover, MRI is free of radiation risk and successful introduction would significantly improve radiation protection is a group of patients likely to be young and with benign problems.

Aims and Objectives: The aim is to produce improvements in clinical management of dental disease. The objectives are to explore refinements in dental examination by MRI, document anatomical and pathological appearances, and to evaluate the clinical role of the investigation. Plan of investigation: Patients will be referred from Oral Surgery at the discretion of the clinician; the project will be covered by principles of clinical experiment in individual patients, although clinical research ethics approval may be needed for specific projects within the whole. Issues of choice of MR sequence and image display parameters will be explored in a pilot study to determine the most efficacious means of investigation. A range of normal appearances will be documented. Multiple cases of mandibular and dental pathology will be used explore the scope of the investigation. MRI findings will be compared with clinical examination, radiographs and outcome to determine the contribution of the technique to clinical management The expected outcome is that MRI will become a valuable adjunct to dental investigation in selected patients, with clinical benefit. The project will proceed until a sufficient cohort of subjects has been examined to give the results validity. It is anticipated that this will take six months. The project builds on previous personal and institutional experience in evaluating MRI in intraosseous disease, and upon the limited work which has been carried out in this area in the world literature.

Requisite Knowledge: Practical clinical MRI. Dental and mandibular anatomy. Surgical management of dental disease. Skills to be acquired: Research design Data analysis

MSc in Diagnostic Imaging

University of Oxford

Section 5 Assessment
Two forms take place; firstly the written assignments that you are required to produce by the end of your first and second terms (second and fourth if you take the course part-time), and your final degree examination. A. Term Assignments You are required to produce one assignment of up to 5,000 words by the end of each of your first two terms of study. The assignments are intended to give an indication to your tutors of the level of your learning on the course, and also to give the course tutors an opportunity to indicate to you how your learning is progressing. Your supervisor will discuss your choice of subject with you. It is important to make these choices early in the term, so that you do not have to rush this work. It is valuable to use the production of your assignment as a means of helping your learning on the rest of the course. In other words, you may like to consider choosing a subject that helps you cover something you must study during that term. Suitable examples might include a detailed account of the physical basis of a particular technique or progress of development of the technique, or an indication of how techniques are used in clinical investigation. In producing your assignment you should demonstrate that you are capable of assembling information from multiple sources into a coherent presentation. Copies of large sections of standard textbooks would not be regarded as acceptable. Assignments are to be handed in to your supervisor before the end of term and you will receive feedback at the beginning of the following term.

B.

The Degree Examination The degree examination is held at the end of the third (or sixth for part-time students) term. The examination consists of three written examination papers, submission of the dissertation and an oral examination. The date of the written examinations is set by the Examination Schools but is usually around eighth or ninth week of Trinity term. You are required to register to enter for your examination and your college will be responsible for handling your registration. The three papers of the written examination follow the general plan of the syllabus. Each paper is divided into two sections, of which the first comprises obligatory questions on the core syllabus, and the second allows the choice between medical and non-medical aspects of the whole syllabus. You should know that examiners frequently expect candidates to use their knowledge across the range of the subject, i.e. a question apparently drawn from one part of the syllabus may require an answer using information from several other parts. The examiners expect written answers to a high standard of clarity and targeted to the set question. If you are not accustomed to examination by written answer you should practice during the course. A seminar on examination preparation will also be held.

Examiners are appointed by the Medical Sciences Division and represent Radiology, Radiography and Medical Physics. There is also an External Examiner, who is responsible for ensuring that the examination is conducted fairly. Round about the time of the written examination you will be asked to submit your dissertation so that it can be marked by the examiners. Note that it is important to have this finished early, so that it does not impede your last revision for the written papers. All candidates attend an oral examination. This is the only time you are likely to meet all the examiners. Oral examinations are usually around 30 minutes long but may be extended if the examiners wish. At the oral examination you may be asked questions on any aspect of the course, written papers, dissertation, or any further element of the syllabus. You may also be shown pieces of equipment or radiographs and questioned on these. The oral examination is usually held around 2-3 weeks after the written papers, at the decision of the Examiners. If you are aware of any aspect of the examination on which you feel you have performed less well than you should, most especially if you feel you have submitted a poor written answer to any question, you are strongly advised to polish these up before the oral examination because the examiners may make a particular point of questioning you on these areas. In the unhappy event of your needing to resit the examination, you should know that although resit examinations are set up at different times for extraordinary reasons, the Universitys usual rule is to insist that candidates take the next formal sitting, i.e. a year later. This may be a practical proposition, depending on your circumstances. You are strongly advised to pass first time! The marking system currently in use is as follows; dissertation 50% written papers 25% oral examination 25%. The pass mark is usually taken as 50% and the Examiners may award a Distinction if your marks exceed 70% of the total.

Attachment: Notes for Guidance of Examination Candidates

University of Oxford

MSc Course in Diagnostic Imaging

Guidance to Candidates on Written Examinations

You are required to take three written examination papers of three hours each. The syllabus for each paper is listed in the Decrees and Regulations. Separate guidance notes are available on the core syllabus. Examination papers consist of two parts. In part A there are six questions which must all be answered. These are intended to test your knowledge of the core syllabus. In part B you are required to choose three questions from a list of 6. The aim is to demonstrate the level of learning you have achieved in studying either the technical or clinical aspects of the subject. You should demonstrate a firm understanding both of principles and of detail in these answers. Each of the optional questions will be marked equally. Although you are free to use the examination time as you wish, it is generally anticipated that you will need one and a half hours to answer the six questions of part A (i.e. 15 minutes each) and one and a half hours to write your three answers to questions from part B (i.e. 30 minutes each). It follows that your answers to questions in part B should be more extensive then those in part A (generally about twice as much). The attached specimen questions are offered as a general guide only.

S J Golding, January 2008

MSc in Diagnostic Imaging

University of Oxford

Section 7

People and Contacts

1. Director of the Course: Dr Stephen Golding The MRI Centre John Radcliffe Hospital Tel: 01865 221904 Email: [email protected] 2. Organising Committee (apart from Dr Golding): Dr Therese Crawley Medical Physics, Churchill Hospital Tel: 01865 225448, email: [email protected] 3. Department Administrator Dr Stella Keeble Nuffield Department of Surgery, John Radcliffe Hospital Tel: 01865 221315, email: [email protected] 4. Chairman of the Departmental Graduate Studies Committee Prof Jon Austyn Nuffield Department of Surgery, John Radcliffe Hospital Tel: 01865 221285, email: [email protected] 5. Head of Department Prof Freddie Hamdy Nuffield Department of Surgery, John Radcliffe Hospital Tel: 01865 221297, email: [email protected] 6. Divisional Secretary Dr David Bryan The Medical School Office, John Radcliffe Hospital Tel: 01865 221681, email: [email protected] 7. Head of Medical Sciences Division Prof Alastair Buchan The Medical School Office, John Radcliffe Hospital Tel: 01865 220548, email: [email protected] 8. Graduate Studies Office Mr. Matt Newman Wellington Square, Oxford, OX1 2JD Tel: 01865 270048, email: [email protected] 9. University Counselling Service Tel: 01865 270300, email: [email protected] 10. Oxford University Computing Service Tel: 01865 221323, email: [email protected] 11. Student Health and Welfare Web: http://www.admin.ox.ac.uk/shw/

Specimen Examination Paper 1 (X-rays, Radiological Procedures, Radiography)

Part A (all questions to be answered) 1. Given an account of exposure factors used in conventional radiography, indicating how each influences the nature of the radiation emitted from the tube. 2. Describe briefly the types of loss of definition (unsharpness) which may occur in conventional radiography. 3. Describe briefly how the intensifying screens used in radiographic cassettes are structures in order to fulfil their objectives. 4. A does of iodine-based contrast medium is injected into a vein in the arm. Briefly describe the biological distribution of the contrast medium there after. 5. Give a brief description of the principle of macro-radiography, indicating the modifications required to equipment for this technique. 6. Indicate the purpose of wearing radiographic film badges, explaining how the information from these is used in practice.

Part B (you are required to answer three questions of your own choice) 7. Define the term linear attenuation coefficient. Explain with the aid of a diagram the variation of this coefficient with energy. Describe and explain the differences you would expect to see between radiographs taken at 30kVp and 90kVp. 8. Draw a labelled diagram of a cross section of an x-ray tube in its housing. Which adjustable parameters affect the patients skin entrance dose during an x-ray exposure and how do they change it? If an x-ray tube delivers 0.05mGy at 2 metres with exposure settings of 100kV, 250mA and 0.02sec; what is the dose at 1metre from 50kV, 10mA and 1sec? 9. Discuss the spectral sensitivity of x-ray films, making particular reference to how the sensitivity is extended. Explain why, in practical radiography, the correct selection of intensifying screens is important in relation to the films in use in the department. 10. Discuss the criteria one should use to evaluate the standard of a radiograph when deciding whether to pass the film for reporting or to repeat the examination. Do not limit your discussion to the radiographic appearances alone. 11. Given an account of the complications which may arise during renal arteriography by the femoral approach, indicating in your answer the steps taken to avoid these. 12. Given an account of the technique of transhepatic percutaneous cholangiography.

Specimen Exam Paper 2 (Nuclear Medicine and Ultrasonography).

Part A (all questions to be answered) 1. Describe in outline the design of a camera (detection system) for gamma-ray scintigraphy. 2. Outline the principles of contrast media design for use in ultrasound. 3. Describe the piezo-electric effect, indicating how this is used in ultrasound probe design. 4. Given a brief account of particle radiation from radioactive nuclides. 5. Describe how ultrasound reacts with tissue, indicating how this is used to characterise tissues. 6. List the characteristics of Technetrum 99m which make it suitable for imaging in clinical practice. Part B (you are required to answer three questions of your own choice) 7. Describe, with diagrams, a scintillation detector and its mode of operation. What types of radiation can be detected? Briefly note any modifications required in design to achieve this. If you use such a detector for measuring very low levels of radioactivity, what would be the special features of the detectors design? 8. Considering a Tc-99m MDP bone scan, explain in general terms how one might estimate the effective doe to the patient. Could you take any steps to change the dose? Indicate whether the dose received in such an examination has any significance for the female reproductive patient. 9. Briefly describe the radionuclide studies which may be used to investigate the hepatobiliary system, indicating the clinical role of each. 10. Give an account of the anatomy of a midline sagittal section of a female pelvis, indicating in your answers the features which may be seen on conventional trans-abdominal ultrasound. 11. What is understood by the terms near field, far field and focal zone? Describe the methods that are available to modify the shape of the ultrasound beam from a single transducer element. Calculate the depth of the near field for a flat signal element transducer operating at 3.5MHz and of diameter 20mm, assuming the speed of sound in tissue is 1500ms-1. 12. Give an account of examination of the thyroid gland by ultrasound, indicating how each of the possible findings influences the management of patients in practice.

Specimen Paper 3 (Computed Tomography and Magnetic Resonance Imaging)

Part A (all questions to be answered) 1. A patient is referred for computed tomography of the abdomen. Describe and outline four of the most important means of reducing the radiation dose to the patient. 2. Describe the basic characteristics of a sectional image in MRI, indicating how each influences the quality of the viewed image. 3. Describe the principle of multislice helical (spiral) computed tomography. 4. What is meant by enhancement in Computed Tomography? Explain briefly how this may be obtained in practice. 5. Briefly explain the role of gradient coils in magnetic resonance scanner design. 6. Indicate the questions that need to asked of patients to ensure that they are safe to undergo examination by magnetic resonance imaging. Part B (you are required to answer three questions of your own choice) 7. Describe, with diagrams where necessary, the principles employed and the equipment required to produce computed tomography (CT images of the body). Compare contrast CT with conventional planar tomography. 8. Describe two pulse sequences and explain their relevance in magnetic resonance imaging (MRI). Highlight the difference between three types of MRI scanner, and justify your choice for a system intended for general usage. 9. Describe the anatomy of an axial cross-sectional of the abdomen at the level of the head of the pancreas. 10. Give an account of the use of magnetic resonance imaging (MRI) in the examination of major vessels of the mediastinum, indicating what features may be revealed. 11. Describe how the technique of high resolution CT of the chest differs from the conventional imaging, indicating what structures may be shown by this technique. 12. Describe the structures of the knee as revealed by magnetic resonance imaging.

S J Golding, January 2003

MSc in Diagnostic Imaging

University of Oxford

Section 6 Where to go in case of Problems

Most students complete their degrees in Oxford without difficulty. However if you should happen to run into problems there is considerable support available throughout the University and at no time should you feel you are on your own.

People you might approach for help include the following. Contact details are provided in Section 7. A. Within the Course 1. Your supervisor 2. The course director, Dr Stephen Golding 3. The organising committee

B. Within the Nuffield Department of Surgery 1. The Department Administrator, Dr Stella Keeble 2. The Chairman of the Graduate Studies Committee, Prof Jon Austyn 3. The Head of Department, Nuffield Professor of Surgery

C. Within your College 1. Your College Advisor 2. The Dean of Graduates 3. The Senior Tutor

D. Within the Division 1. The Divisional Secretary (Secretary of the Medical School), Dr David Bryan 2. Chairman of the Medical Sciences Board or the Educational Policy and Standards Committee

E. Within the University 1. The Graduate Studies Office 2. The University Counselling Service

MSc in Diagnostic Imaging

University of Oxford

Section 7

People and Contacts

1. Director of the Course: Dr Stephen Golding The MRI Centre John Radcliffe Hospital Tel: 01865 221904 Email: [email protected] 2. Organising Committee (apart from Dr Golding): Dr Therese Crawley Medical Physics, Churchill Hospital Tel: 01865 225448, email: [email protected] 3. Department Administrator Dr Stella Keeble Nuffield Department of Surgery, John Radcliffe Hospital Tel: 01865 221315, email: [email protected] 4. Chairman of the Departmental Graduate Studies Committee Prof Jon Austyn Nuffield Department of Surgery, John Radcliffe Hospital Tel: 01865 221285, email: [email protected] 5. Head of Department Prof Freddie Hamdy Nuffield Department of Surgery, John Radcliffe Hospital Tel: 01865 221297, email: [email protected] 6. Divisional Secretary Dr David Bryan The Medical School Office, John Radcliffe Hospital Tel: 01865 221681, email: [email protected] 7. Head of Medical Sciences Division Prof Alastair Buchan The Medical School Office, John Radcliffe Hospital Tel: 01865 220548, email: [email protected] 8. Graduate Studies Office Mr. Matt Newman Wellington Square, Oxford, OX1 2JD Tel: 01865 270048, email: [email protected] 9. University Counselling Service Tel: 01865 270300, email: [email protected] 10. Oxford University Computing Service Tel: 01865 221323, email: [email protected] 11. Student Health and Welfare Web: http://www.admin.ox.ac.uk/shw/

ANNEX

Academic integrity: good practice in citation, and the avoidance of plagiarism

The Universitys code of conduct concerning academic integrity is set out on the website at http://www.admin.ox.ac.uk/rso/integrity/ and, while the codes principles relate specifically to the conduct of research, all graduate students are advised to make themselves aware of the documents contents. The code of conduct mentions plagiarism, and in this context it is important for all taught course and research students within the divisions subject areas, to be aware of, and to follow, good practice in the use of sources and making appropriate reference. You will need to exercise judgement in determining when reference is required, and when material may be taken to be so much a part of the general knowledge of your subject that formal citation would not be expected. The basis on which such judgements are made is likely to vary slightly between subject areas, as may also the style and format of making references, and your supervisor, or course organiser where appropriate, will be in the best position to advise you on such matters; in addition, these may be covered, along with other aspects of academic writing, in your induction training. You are advised to take the online course Good Practice in Citation and the Avoidance of Plagiarism available at http://www.medsci.ox.ac.uk/portal/skillstraining/courses/plagiarism/ By following the citation principles and practices in place in your subject area, you will develop a rigorous approach to academic referencing, and avoid inadvertent plagiarism. Cases of apparently deliberate plagiarism, while happily infrequent in the University, are taken extremely seriously, and where examiners suspect that this has occurred, they bring the matter to the attention of the Proctors. Your attention is drawn to the Proctors and Assessors Memorandum, Sections 9.5 Plaigarism, in particular: The University reserves the right to use software applications to screen any individuals submitted work for matches either to published sources or to other submitted work. In some examinations, all candidates are asked to submit an electronic copy of essays, dissertations etc. for screening by Turnitin. Any matches might indicate either plagiarism or collusion. Although the use of electronic resources by students in their academic work is encouraged, you should remember that the regulations on plagiarism apply to on-line material and other digital material just as much as to printed material If university examiners believe that material submitted by a candidate may be plagiarised, they will refer the matter to the Proctors. The Proctors will suspend a students examination while they fully investigate such cases (including interviewing the student). If they consider that a breach of the Disciplinary Regulations has occurred, the Proctors are empowered to refer the matter to the Student Disciplinary Panel. Where plagiarism is proven, it will be dealt with severely: in the most extreme cases, this can result in the students career at Oxford being ended by expulsion from the University. Your attention is also drawn to Section 9.6 Conduct in Examinations (in particular to sections 4 and 5): Medical Sciences Division Notes for Guidance 2008-09: 4. No candidate shall present for an examination as his or her own work any part or the substance of any part of another persons work. 5. In any written work (whether thesis, dissertation, essay, coursework, or written examinations) passages quoted or closely paraphrased from another persons work must be identified as quotations or paraphrases, and the source of the quoted or paraphrased material must be clearly acknowledged.