Imaging

UHB provides a comprehensive range of diagnostic and interventional procedures utilising high specification imaging equipment. This is supported by the latest image evaluation software, distributed via the ultimate in PACS (Picture Archiving Communication Systems) management platforms.

The department plays a key part in the treatment of the more than 806,000 patients who are treated at the hospital every year.

The department has inpatient and outpatient facilities, as well as dedicated scanners located in the Emergency Department. This separate emergency imaging facility means access to the main imaging services can be planned more effectively, a key element in supporting research which requires regular and precisely scheduled imaging.

Imaging Facilities

QEHB runs inpatient and outpatient imaging separately but as part of integrated department on a single floor.

These services are available during extended hours to cater to patients needing scans outside normal working hours.

A&E Outpatient Inpatient Total
Normal X-rayX-ray scanning uses a form of electromagnetic radiation known as X-radiation, which is also called Röntgen radiation. X-rays are produced by applying high voltage electricity to a vacuum tube with an anode at one end and a cathode at the other. When electricity is applied, electrons are emitted by the anode and strike the cathode, where some of the energy is emitted as X-rays. The rays can then be directed at the body, but are stopped by dense body structures such as bone. The rays which pass through the body can then be used to create an image 3 4 4 11
MRIAn MRI machine uses a powerful magnetic field to align the magnetisation of targeted atoms in the body, and radio frequency fields to systematically alter the alignment of this magnetisation. This causes the nuclei of those atoms to produce a rotating magnetic field, which is detectable by the scanner. This information is used to construct an image of the scanned area of the body. 4 2 6
CTComputed tomography is a form of X-ray scanning in which multiple X-rays are taken from different directions. The data collected is then manipulated by a computer to create very precise images of different structures within the body. 1 2 2 5
UltrasoundUltrasound scanners use sound waves at a frequency much higher than the human ear can detect. These waves are reflected by parts of the body such as muscles and internal organs, and the scanner detects these changes to the waves to create an image. It is often used during pregnancy to visualise the foetus. 1 4 3 8
FluoroscopyFluoroscopy is an imaging technique used to obtain real-time moving images of the internal structures of a patient. A fluoroscope consists of an X-ray source and fluorescent screen. The patient is placed between these. 3 2 5
OrthopantomogramAn orthopantomogram is a specialist scanner which produces a flat image of a patient’s jaw, and is used to diagnose dental and cranio-facial problems and plan treatment. One of these machines includes a lateral cephalogram. 1 1 2
AngiographyAngiography, which is also known as arteriography, is an imaging technique used to create images of the inside of blood vessels and organs of the body. It is of particular use in looking at the arteries, veins and the heart chambers. This normally involves injecting an agent into the blood vessel. 5 5
SPECT-CTSPECT-CT uses a combination of a gamma camera and a CT machine, which takes a number of X-rays to create detailed images of the body’s structures 3 3
PET-CTPET stands for positron emission tomography, and uses biologically active positron-emitting substances, for example to image tissue metabolic activity. 1 1

Imaging Services

The Imaging Department provides the full range of clinical imaging requirements of a large University teaching hospital, yet is also adaptable to individual research needs.

In particular, the MRI suite of equipment is used to carry out non-standard scans which are requested and approved as part of the required research approvals process.

The hospital’s Imaging and Nuclear Medicine teams play a major role in preparing research bids to ensure the necessary resources are available and that any imaging components are consistent with patient safety and care.

The Imaging department has staff dedicated to coordinating research activity. They coordinate research imaging with regular clinical activity and have a key role in ensuring all imaging events are scheduled according to the relevant protocols. They also play a role in ensuring consistency of scanning methodlogy and compliance with relevant governance requirements.

Support for research

The imaging department plays a key role in research activity across all specialties at UHB, including both cancer and non-cancer studies.

Collaborations

The extent and configuration of UHB’s Imaging Department means it is often used by other hospitals to support their own research work.

In particular, the Department has provided imaging support to research being carried out by Birmingham Women’s Hospital NHS Foundation Trust, the Royal Orthopaedic Hospital NHS Foundation Trust, Heart of England NHS Foundation Trust and Walsall Healthcare NHS Trust and Sandwell and West Birmingham Hospitals NHS Trust.

Nuclear medicine

Nuclear medicine involves the use of radioactive materials to create images or deliver treatment, and both these capabilities are important in a wide range of research activities.  The Nuclear Medicine Department operates as an integral part of the imaging service providing support to a broad range of research programmes.

Gamma camera 

A gamma camera takes images by detecting the presence of a radioactive substance which has been introduced to the patient’s body, by injection, inhalation or ingestion. The substance used emits gamma rays, which are detected by the machine and converted into visual images.  Different substances are used depending on the type of scan required.

SPECT-CT

The SPECT-CT machine uses a combination of a gamma camera and a CT machine, which takes a number of X-rays to create detailed images of the body’s structures. By merging the gamma camera and CT images, the SPECT-CT creates a new image which shows the distribution of the radioactive substance in relation to internal structures such as bones and organs.

PET-CT

The PET-CT scan uses a similar principle to the SPECT-CT, but uses a different type of radioactive material and detector.  PET stands for positron emission tomography, and uses  biologically active positron-emitting substances, for example to image tissue metabolic activity.

DXA

A DXA scanner is a dual energy x-ray system that takes pictures and measures the density of bone in different parts of the body. This is used for osteoporosis diagnosis and research.

Non-imaging capabilities

Nuclear medicine can also be used to provide data which is not presented as an image.

These measurements include:

  • Glomerular filtration rate, the gold standard for establishing kidney function
  • Red cell mass
  • Plasma volume

Therapies

The use of nuclear medicine in research is not limited to generating data. Some research looks at how the use of radioactive materials can actually help treat conditions.

UHB has a radiopharmacy on site to prepare the materials it uses for such therapies, some of which are part of research programmes.