CT SCAN (ACTIVION 16-SLICE)

INTRODUCTION
The Radiology department in IMC uses the Activion 16-slice CT machine, developed by
Toshiba. This state-of-the-art system utilizes a multi-detector array that captures multiple image
slices simultaneously, allowing for high-resolution scanning of the human body. During the
rotation, I had the opportunity to witness firsthand the seamless integration of the Activion 16-
slice CT machine. The Activion 16-slice CT machine delivered precise cross-sectional images,
aiding in accurate diagnosis and treatment planning. The department's professionals exhibited
expertise in patient preparation, positioning, and image analysis.

DEPARTMENT OVERVIEW
The Radiology department at IMC is organized to provide efficient and comprehensive imaging
services. The examination room housing the CT machine is equipped with a comfortable CT
scan table (length = xyz) and a gantry that houses the Activion 16-slice CT machine. The room
is designed to ensure patient comfort and accessibility during the scanning process. Adjacent to
the examination room, the control room allows technologists and radiologists to monitor the
scanning procedure and adjust the imaging parameters as necessary.

Figure 1: CT machine Figure 2: CT contrast injector

Within the CT scan department, there is also a separate area dedicated to the preparation and
administration of contrast agents. This area includes a contrast agent injector device (Visimax
CT Contrast Injector, developed by IMAXEON), which is used to deliver contrast material
into the patient's bloodstream during certain CT scans. The presence of this device underscores
the department's capability to perform contrast-enhanced imaging studies, providing valuable
diagnostic information for various medical conditions.
In addition to the efficient layout of the Radiology
department at IMC, it incorporates necessary safety
measures to ensure radiation protection. The walls and
glass of the CT scan examination room are clad with lead,
providing effective shielding against radiation exposure.
This lead cladding helps contain and minimize radiation
leakage, safeguarding both patients and healthcare
professionals from unnecessary radiation exposure during
the scanning process.

The safety protocols for radiation protection are further

reinforced by the presence of lead aprons. These lead
aprons are essential personal protective equipment (PPE)
worn by those healthcare professionals that are sometimes
required to assist the patient during the procedure in the
examination room.

The lead aprons are specifically designed to provide a Figure 3: Lead apron
shielding barrier, effectively reducing radiation exposure
to the vital organs and sensitive areas of the body, such as the abdomen and reproductive organs.
They are made with a lead-infused material that offers high attenuation properties against
radiation.

CT PROCEDURE
The CT procedure at the Radiology department in IMC encompasses a series of steps tailored to
meet the specific diagnostic needs of each patient. During my assignment, I observed the
procedure on two patients, each with distinct requirements and imaging protocols.

The first patient presented with symptoms related to sinus issues, and therefore, a sinus CT scan
was performed. The technologist positioned the patient on the CT scan table, ensuring proper
alignment for accurate image acquisition. The Activion 16-slice CT machine swiftly captured a
series of images focused on the head region. In total, 364 images were acquired, providing
comprehensive coverage of the sinuses.

Upon review of the images, it was noted that the requesting physician had specifically asked for
coronal views. To accommodate this, a selection of 42 result images was made. Of these selected
images, more than half were in the coronal plane, allowing for a detailed evaluation of the
sinuses from multiple angles. The remaining images were distributed among the sagittal and
axial planes, providing a comprehensive representation of the sinus anatomy.

The second patient required a broader assessment, necessitating a head, neck, and chest CT scan.
Similar to the previous patient, the technologist positioned the individual on the CT scan table,
ensuring proper alignment. The Activion 16-slice CT machine rapidly acquired a more extensive
series of images, resulting in a total of 1627 scans.
As part of the imaging protocol for the second patient, non-ionic contrast agent (Iohexol) was
administered intravenously. This contrast agent enhances the visibility of blood vessels and
certain structures, aiding in the evaluation of the head, neck, and chest regions. The
administration of contrast material was carefully monitored to ensure patient safety and optimal
image quality.

The standard slice thickness utilized for the sinus patient was 4mm. This slice thickness
determines the level of detail captured in the images. A thinner slice thickness allows for a
higher resolution, enabling better visualization of smaller structures. The choice of 4mm slice
thickness in this case ensures adequate coverage of the sinuses while maintaining diagnostic
quality.

The CT procedure, tailored to the specific requirements of each patient, demonstrates the
department's commitment to providing comprehensive and accurate diagnostic imaging services.
The seamless integration of the Activion 16-slice CT machine, coupled with the expertise of the
healthcare professionals, ensures optimal patient care and precise diagnostic outcomes.

DISCUSSION
During the rotation in the CT scan department, I had the opportunity to engage in a fruitful
discussion with the team present. The following questions were asked, along with their
corresponding answers:

Question 1: What factors determine the selection of different imaging planes (coronal,
sagittal, axial) in CT scans?

Answer: The selection of imaging planes depends on the clinical indication and the preferences
of the requesting physician. In the case of the sinus patient, the physician specifically requested
coronal views to assess the sinuses. Other cases may require different planes based on the
anatomical region of interest and the diagnostic information needed.

Question 2: What is the purpose of using a contrast agent in CT scans?

Answer: Contrast agents are used in CT scans to help doctors get a clearer and more detailed
view of certain structures or conditions inside the body. They work by highlighting blood
vessels, organs, or tissues, making them stand out more prominently on the CT images. By
enhancing the contrast between different structures, the contrast agent enables radiologists to
better identify and evaluate abnormalities, such as tumors or vascular issues.

Question 3: How do contrast agents work in CT scans to improve the visibility of structures
within the body?

Answer: Contrast agents used in CT scans work by altering the way X-rays interact with the
body's tissues. These agents contain substances, such as iodine or barium that have high atomic
numbers and can effectively absorb X-rays.
When the contrast agent is administered into the body, either orally, intravenously, or through
other routes depending on the specific examination, it circulates through the bloodstream or
reaches the targeted area. As the X-ray beams pass through the body during the CT scan, the
contrast agent absorbs some of the X-rays, resulting in areas where the agent is present appearing
brighter on the images.

This differential absorption of X-rays creates a contrast between the structures or organs that
have taken up the contrast agent and those that haven't. It enhances the visibility of blood vessels,
organs, or lesions, making them more distinguishable from surrounding tissues. This increased
contrast enables radiologists to better identify abnormalities, detect tumors, assess blood flow,
and evaluate various conditions.

The choice of the specific contrast agent and its administration route depends on the area of
interest and the clinical indication. Radiologists and medical professionals carefully consider
factors such as the patient's medical history, allergies, and renal function before selecting and
administering a contrast agent.

Question 4: Why are non-ionic contrast agents used?

Answer: Non-ionic contrast agents are used in medical imaging procedures, like CT scans,
because they are considered safer and have a lower risk of causing adverse reactions compared to
ionic contrast agents. They are designed to be less likely to cause allergic or hypersensitivity
reactions in patients.

Question 5: What are the main differences between CT scan, x-ray, mammography,
fluoroscopy, MRI scan, and ultrasound?

Answer:

1. CT scan:
 Utilizes X-ray technology to create detailed cross-sectional images of the body.
 Provides detailed visualization of bones, soft tissues, and organs.
 Can detect various conditions, including tumors, fractures, and internal injuries.
 Involves exposure to ionizing radiation.
2. X-ray:
 Uses X-ray beams to produce 2D images of the body.
 Primarily used to examine bones and assess conditions such as fractures or dislocations.
 Quick and non-invasive procedure.
 Involves exposure to ionizing radiation.
3. Mammography:
 Specialized X-ray imaging of the breasts.
 Primarily used for breast cancer screening and diagnosis.
 Detects early signs of breast abnormalities, such as tumors or calcifications.
 Uses lower X-ray doses compared to traditional X-rays.
4. Fluoroscopy:
  Real-time X-ray imaging technique.
 Involves continuous X-ray beams to capture moving images of organs or systems in
action.
 Frequently used for procedures like barium studies or cardiac catheterization.
 Involves exposure to ionizing radiation.
5. MRI (Magnetic Resonance Imaging):
 Uses strong magnetic fields and radio waves to generate detailed images of the body.
 Provides excellent soft tissue visualization.
 Often used for imaging the brain, spine, joints, and internal organs.
 Does not involve ionizing radiation but is contraindicated for patients with certain
metallic implants.
6. Ultrasound:
 Utilizes high-frequency sound waves to create images of internal structures.
 Particularly useful for imaging the abdomen, pelvis, and fetus during pregnancy.
 Non-invasive and does not involve ionizing radiation.
 Provides real-time imaging and can assess blood flow using Doppler technology.

Question 6: What is the cost of the CT machine? How often is maintenance required for the
CT machine? What are the associated maintenance costs? What is the typical life
expectancy of a CT machine?
 ULTRASOUND (GE LOGIQ 7)

INTRODUCTION

During my ultrasound rotation, I had the opportunity to immerse myself in the dynamic world of
medical imaging within the ultrasound department. The department primarily utilized the GE
Logiq 7 ultrasound machine, a cutting-edge technology designed to provide high-quality imaging
for various diagnostic purposes, made in America. Throughout the rotation, I witnessed firsthand
the crucial role that ultrasound plays in diagnosing and monitoring a wide range of medical
conditions. From obstetrics and gynecology to abdominal imaging, and beyond, ultrasound has
become an indispensable tool in the diagnostic arsenal of healthcare professionals. The GE Logiq
7 machine, known for its advanced features and imaging capabilities, served as the primary
instrument for acquiring high-resolution ultrasound images

DEPARTMENT OVERVIEW

The ultrasound department I had the privilege of rotating in was a well-organized and efficient
unit dedicated to providing high-quality diagnostic imaging services. The department consisted
of two adjacent rooms, each with a specific purpose, seamlessly working together to ensure
optimal patient care and accurate reporting.

The first room served as the examination area, equipped with GE Logiq 7 ultrasound machine.
This room was designed to facilitate patient comfort and convenience during the scanning
process. It was equipped with a comfortable examination bed, essential accessories, and a variety
of transducers tailored for different imaging needs. The skilled radiologists and sonographers
conducted ultrasound examinations with precision and expertise, ensuring optimal image
acquisition and patient satisfaction.

Adjacent to the examination room was a separate workspace dedicated to report generation and
data analysis. This area was manned by a computer specialist proficient in interpreting
ultrasound findings and generating detailed reports.

One notable feature observed was the presence of an online uninterruptible power supply (UPS)
system connected to the ultrasound machine. The UPS serves as a backup power source to ensure
continuous operation of the ultrasound equipment, even in the event of a power outage or
fluctuation. The online UPS system is designed to provide instant and seamless power backup,
preventing any interruption or loss of data during critical ultrasound examinations. It offers
protection against power surges, voltage fluctuations, and sudden power cuts, which are crucial
for maintaining uninterrupted workflow and preventing potential disruptions in patient care.

Patient care and safety were paramount within the department. Infection control measures,
proper patient positioning, and adherence to ethical guidelines were consistently observed. The
sonographers and technologists demonstrated compassion and professionalism, ensuring patient
comfort and establishing a trusting rapport throughout the ultrasound examination process.

GE LOGIC SERIES
The GE Logiq 7 ultrasound machine is a highly advanced and versatile imaging system used
extensively in the ultrasound department. Known for its exceptional image quality and wide
range of imaging capabilities, the Logiq 7 offers a comprehensive set of parameters, buttons, and
options that enhance the imaging experience. Let's explore the various aspects of this powerful
ultrasound machine in detail:

USER INTERFACE AND DISPLAY:

The Logiq 7 features a user-friendly interface with a high-resolution color display, allowing for
clear visualization of ultrasound images.
The display screen is adjustable, enabling optimal positioning for different scanning angles and
user preferences.
1. Transducers:
 The machine supports a wide
selection of transducers designed for
specific applications and body
regions. The transducers present in
the room at the moment were
convex and linear.
 Each transducer is equipped with a
specific frequency range, allowing
for optimal imaging depth and
resolution based on the patient's
anatomy.
2. Imaging Modes:
The Logiq 7 offers a range of imaging
modes, including:
 2D Mode: Provides real-time
grayscale imaging to visualize the
anatomical structures and tissues.
 Color Doppler Mode: Enables the
assessment of blood flow velocity
and direction, represented by color-
coded overlays on the 2D image.
 Power Doppler Mode: Offers
enhanced sensitivity for detecting
Figure 4: GE Logiq 7 ultrasound machine
blood flow, particularly useful in
low flow or vascular studies.
3. Imaging Parameters:
The Logiq 7 provides extensive control over imaging parameters, allowing the sonographer
to customize the imaging settings based on the patient and examination requirements. These
parameters include:
  Gain: Adjusts the overall brightness of the image.
 Depth: Controls the depth of penetration for imaging.
 Focus: Sets the focal depth to optimize image clarity at a specific depth.
 Time Gain Compensation (TGC): Adjusts the gain at different depths to compensate for
variations in tissue attenuation.
 Frequency: Selects the operating frequency of the transducer for optimal image
resolution.
4. Image Optimization Tools:
The machine offers a variety of image optimization tools to enhance image quality and
diagnostic accuracy, such as:
 Zoom: Allows magnification of specific areas of interest for detailed examination.
 B-Flow Imaging: Provides enhanced visualization of blood flow using advanced
beamforming techniques.
 Speckle Reduction Imaging (SRI): Reduces image noise and enhances tissue definition.
 Compound Imaging: Combines multiple scan lines from different angles to improve
image clarity and reduce artifacts.
5. Measurement and Analysis Tools:
The Logiq 7 provides a range of measurement and analysis tools to quantify various
parameters and assist in diagnostic decision-making. These include:
 Distance, area, and volume measurements
 Doppler measurements, such as velocity and acceleration
6. Workflow and Data Management:
The machine is equipped with features that streamline workflow and facilitate efficient data
management, such as:
 Patient data entry and storage
 Image and video capture
 Report generation and archiving capabilities

The GE Logiq 7 ultrasound machine offers a comprehensive array of parameters, buttons, and
options that enable detailed and accurate imaging across various clinical applications. It’s
advanced imaging modes, customizable settings, and powerful image optimization tools
contribute to its effectiveness in diagnostic imaging and patient care.
 Pathology lab

Introduction

During my rotation in the pathology lab, I had the privilege of gaining hands-on
experience and expanding my knowledge in the field of laboratory medicine. The
pathology lab serves as a critical component of the healthcare system, playing a vital
role in disease diagnosis and patient care. Throughout this rotation, I had the
opportunity to work with a range of equipment and instruments, each serving a specific
purpose in analyzing patient samples. By immersing myself in the lab environment, I
witnessed firsthand the intricate processes involved in sample analysis, quality control
measures, and the collaborative efforts of the lab team. This experience has not only
deepened my understanding of laboratory diagnostics but has also provided valuable
insights into the essential role of biomedical engineering in supporting accurate and
timely clinical diagnostics.

Equipment and instrumentation

The instruments used in the pathology laboratory are designed to perform specific tests
and analyses on patient samples, enabling the identification and characterization of
various diseases and conditions. The equipments I encountered during my assignment
were:

Mindray CL-1000 Automatic Analyzer

The Mindray CL-1000 Automatic Analyzer is a sophisticated and advanced instrument
used for clinical chemistry testing in the pathology lab. It incorporates a range of
functions and features that enable efficient and accurate analysis of patient samples.

1. Functionality: The CL-1000 is designed to perform a wide array of clinical chemistry

tests, covering a comprehensive range of biochemical parameters. It allows for the
analysis of blood, serum, plasma, and other body fluids to assess various aspects of
patient health and organ function.
2. Sample Processing: The analyzer can handle multiple samples simultaneously,
streamlining the workflow in the laboratory. It has a sample carousel or rack system that
can accommodate a large number of samples at once. This enables high-throughput
analysis, increasing the efficiency of sample processing.
3. Assay Menu: The CL-1000 offers an extensive assay menu, including tests for liver
function, kidney function, lipid profile, electrolyte balance, glucose levels, and more. It
supports a broad range of reagents and methodologies to provide accurate and reliable
results for different parameters.
4. Automation: The analyzer is fully automated, reducing the need for manual intervention
and minimizing the risk of errors. It can perform sample dilutions, pipetting, mixing,
incubation, and result calculation automatically. This automation enhances precision and
standardization in the testing process.
5. User-Friendly Interface: The CL-1000 features a user-friendly interface with a graphical
display and intuitive navigation. It allows laboratory personnel to easily navigate
through menus, set up tests, monitor the progress of analysis, and review results. The
interface provides real-time updates and alerts for any system issues or maintenance
requirements.
6. Quality Control: The analyzer incorporates robust quality control features to ensure the
accuracy and reliability of test results. It includes built-in quality control checks,
calibration options, and the ability to track and monitor quality control data over time.
This helps maintain the integrity of testing and ensures adherence to quality assurance
protocols.
7. Connectivity and Data Management: The CL-1000 offers connectivity options for
seamless integration with laboratory information systems (LIS) and other data
management systems. It enables the transfer of patient and test data, result reporting,
and the generation of comprehensive reports for easy documentation and analysis.
8. Instrumentation: The CL-1000 utilizes advanced technologies such as
spectrophotometry, enzymatic reactions, and immunoassays for measurement and
detection. It employs precise optical systems, sensitive detectors, and sophisticated
algorithms to analyze the reactions and provide accurate and reproducible results.

The Mindray CL-1000 Automatic Analyzer is a reliable and efficient instrument that plays
a crucial role in clinical chemistry testing. Its comprehensive functionality, automation
capabilities, and user-friendly interface contribute to enhanced laboratory productivity,
accurate diagnosis, and effective patient care.