Clinical Radiology

Data

Official data in SubjectManager for the following academic year: 2019-2020

Topic

The Medical Student Education Program of the Department of Radiology is active in the fourth year of the medical student curriculum, training not only future radiologists, but also future physicians of all specialties. We realize that most of our students will not be going
into Radiology, but all of our students will be using radiology as a tool in the care of their patients. Our goal is to provide a firm grounding in the basic knowledge and skills of our field as well as instruction on how to interact with radiology and radiologists to get the most benefit for your patients. In addition, the major features and applications of nuclear medicine methods are also integrated in the lectures and clinical practices.

Lectures

• 1. Introduction, physics, radiation protection I. - Dr. Bogner Péter
• 2. Introduction, physics, radiation protection II. - Dr. Bogner Péter
• 3. X-ray devices, CT, nuclear medicine devices I. - Dr. Bogner Péter
• 4. Nuclear medicine basics, techniques and devices. - Dr. Bódisné Dr. Zámbó Katalin
• 5. Ultrasound - Dr. Bogner Péter
• 6. MR - Dr. Bogner Péter
• 7. Chest - Dr. Battyáni István
• 8. Chest - nuclear medicine - Dr. Bódisné Dr. Zámbó Katalin
• 9. Cardiovascular system - Dr. Várady Edit
• 10. Cardiovascular system - nuclear medicine - Dr. Bódisné Dr. Zámbó Katalin
• 11. Gastrointestinal system - Dr. Faluhelyi Nándor
• 12. Gastrointestinal system system - nuclear medicine - Dr. Bódisné Dr. Zámbó Katalin
• 13. Breast, female pelvis - Dr. Farkas Orsolya
• 14. Breast, female pelvis - nuclear medicine - Dr. Schmidt Erzsébet
• 15. Head and neck - Dr. Rostás Tamás
• 16. Head and neck - nuclear medicine - Dr. Bán Zsuzsanna
• 17. Musculoskeletal system - Dr. Giyab Omar
• 18. Musculoskeletal system - nuclear medicine - Dr. Schmidt Erzsébet
• 19. Neuroradiology - Dr. Rostás Tamás
• 20. CNS - nuclear medicine - Dr. Molnárné Dr. Szabó Zsuzsanna
• 21. Urogenital system - Dr. Faluhelyi Nándor
• 22. Urogenital system - nuclear medicine - Dr. Molnárné Dr. Szabó Zsuzsanna
• 23. Pediatric radiology - Dr. Péleyné Dr. Mohay Gabriella
• 24. Pediatric nuclear medicine imaging - Dr. Bán Zsuzsanna
• 25. Vascular intervention - Dr. Battyáni István
• 26. Non-vascular intervention - Dr. Battyáni István
• 27. The process of radiology exam ordering. The interpretation of radiology reports - Dr. Faluhelyi Nándor
• 28. Radioisotope therapic methods with alpha and beta emitting radiopharmacons. - Dr. Schmidt Erzsébet

Practices

• 1. Inroduction to the diagnostic X-ray workplace, characteristics of a radiation hazardous workplace. Basics of radiation protection (protection equipment, distance, modification of the aperture diaphragm, time, etc).
• 2. Specialities of radiation protection in nuclear medicine. Explanation of the hazards of the radiation to the patient. ALARA in practice. Choice of examination methods and radiation hygiene.
• 3. Introduction to the mammography, CT and DSA workplace, modality-image recognition. Recognition of poor image quality. Hounsfield scale, windowing.
• 4. Advantages and disadvantages of radiological interventions. Content of the radiology referral. Communication of the examinations to the patient. Features of a diagnostic test (pre-and post test probabilities).
• 5. Introduction to the US and MRI workplace. Recognition of types and planes of the MR images. Recognition of poor image quality. Patient preparation for a contrast-enhanced examination.
• 6. Nuclear medicine workplace.
• 7. Identification of the structures listed below on the PA and lateral chest radiograph: lobes and fissures, trachea, main bronchi, atria and ventricles, pulmonary arteries, aorta, structures of the mediastinum, diaphragm. Examinations and communication of the results to the patient. Recognition of the position of the intrathoracic medical equipments (endotracheal tube, central venous pressure line, nasogastric tube, intercostal drain, pacemaker).
• 8. Identification of pneumonia, emphysema, space occupying lesions of the lungs and mediastinum, pleural effusion on CT and X-ray images. Recognition of pneumothorax and tension pneumothorax on chest X-ray images.
• 9. Types of cardiomegaly, pulmonary venous congestion, pulmonary edema, radiographic features. Examination of occlusion, stenosis, thrombosis with US/Doppler, CT, MRI. Coronary CT, heart MRI. Pulmonary embolism.
• 10. Examinations and communication of the results to the patient.
• 11. Recognition of normal abdominal anatomy on X-ray, US, CT és MRI images. Recognition of signs of ileus/gastrointestinal obstruction and perforation on X-ray images.
• 12. Examinations and communication of the results to the patient.
• 13. Breast: Examination, communication, advantages and limits of the medical imaging methods. Main breast diseases, mammographic and US features.
• 14. Female pelvis: Recognition of anatomical structures on US, CT and MRI images. Examinations and communication of the results to the patient. Selection of the adequate imaging method in pregnant women.
• 15. Head and neck: Identification of anatomical structures on US, CT and MRI images.
• 16. Examinations and communication of the results to the patient.
• 17. Identification of anatomical musculoskeletal structures on X-ray, US, CT and MRI images. Recognition of the common fractures on X-ray images.
• 18. Examinations and communication of the results to the patient.
• 19. Neuroradiology: Identification of anatomical structures on CT and MRI images. Recognise and differentiate the intracranial bleedings. Recognise the signs of the spinal cord compression. Inclusion (foramen magnum).
• 20. Examinations and communication of the results to the patient.
• 21. Urogenital system on axial images. Recognition of the signs of obstruction on US, CT and MRI images.
• 22. Examinations and communication of the results to the patient.
• 23. Identification of anatomic pediatric skeletal structures and structures of the chest on X-ray images. Diagnostics of bone fractures on X-ray images.
• 24. Examinations and communication of the results to the patient, and to the parents.
• 25. Nuclear medicine practice I. Introduction to the main examinations in practice and in the basis of archive images.
• 26. Nuclear medicine practice II. Principles, main indications, evaluation of the examinations.
• 27. Interventional radiology: Biopsy, punction, drainage. Angiography (analog, DSA). PTA, thrombolysis, diagnostics of bleedings, treatment. Basic angiographic examinations, pressure measurment, mini doppler.
• 28. Interventional oncoradiology. Angiographic signs of tumors. Selective cytostatic treatment, embolisation. Importance of praeoperetiv embolisation. Staunching the bleeding of tumors. Radiological aspects of the tumors of the oesophagus, colon and biliary ducts.

Seminars

Reading material

Obligatory literature

Literature developed by the Department

Notes

Recommended literature

Herring: Learning Radiology, Saunders, 2015
R. B. Gunderman: Essential Radiology, Thieme, 2006
G. M. Roberts, J. P. Hughes and M. D. Hourihan: Clinical Radiology for Medical Students
S. Francis, A. F. Watkinson (Department of Radiology of The Royal Free Hospital, London, UK): Interventional Radiology
Explained, Remedicina Publishing, 2000.
In Hungarian:
Fráter, Palkó, Makó, Kollár, Battyáni: Radiológia, Medicina, 2014
Recommended: Davit Sutton: Textbook of Radiology and Imaging, latest edition, Elsevier

Conditions for acceptance of the semester

The completion of Clinical Radiology course will be verified in case of maximum two absences from clinical practices (4 hours). To recover the absences over the limit, the permission of clinical director is needed (e.g. in case of health problems that is legally documented).
The "A" chance for the exam is a written test consisting of simple choice, multiple choice, true-false and relation analysis questions. The test also contains image analysis: examination methods, important anatomical structures and basic pathologies are expected to be recognized. In case of fail, chance "B" and "C" are oral exams, during which 3 different questions (from the topics below) are required to talk about. Only those sudents will be able to sign up for exam "B" who were previously signed up for exam "A".

Mid-term exams

During each lecture an online test, using "Kahoot!" (https://kahoot.it/) mobile appliaction, will be performed. Depending on the perticipation rate the students will get expra point(s) for the written exam (but only, if they pass the exam without those exra points).

Making up for missed classes

Recovering absences over the limit is possible by attending practices with a different group but similar topic.

Exam topics/questions

1.The fundamentals of X-ray imaging. X-ray equipments. Radiation protection.
2.The fundamentals of CT and MRI imaging, examination methods.
3.Fundamentals of ultrasound physics. Ultrasound methods. Patient preparation before examination.
4.Imaging of pneumonias.
5.Thoracic masses. Imaging strategy, differential diagnosis.
6.Pulmonary embolism. Diagnosis and diagnostic difficulties.
7.Pneumothorax and hydrothorax. Etiology, radiologic characteristics.
8.Interstitial pulmonary diseases. Pulmonary fibrosis. Silicosis. Emphysema.
9.Diagnostic imaging of cardiac diseases. Methods, indications. Cardiomyopathies. Diseases of the pericardium.
10.Imaging of ischemic heart diseases and cardiac valve diseases.
11.Diseases of the aorta. Imaging methods, the role of CT and MRI.
12.Imaging in acute abdomen.
13.Imaging of the esophagus, stomach and small bowels. Methods, indications, imaging strategy.
14.Imaging of the colon. Inflammatory diseases of the colon. Diverticulosis. Colon tumors.
15.Imaging of the liver and the hepatobiliary system. Imaging techniques, indications, information content.
16.Imaging of the pancreas and the spleen. Imaging techniques, indications, information content.
17.Imaging of the urinary system. Indications, diagnostic strategy. Renal inflammatory diseases, nephrolithiasis.
18.Onco-uroradiology: Adrenal and renal masses. Masses of the urinary bladder, the prostate and the testis. Imaging techniques and strategy.
19.Imaging of the arterial system and arterial diseases. Methods of angiography. Indications and complications.
20.Imaging of the venous and lymphatic system and their diseases. Deep vein thrombosis.
21.Imaging of musculoskeletal trauma (bones and soft tissue). Radiologic signs of fracture healing. Terminology.
22.Imaging of degenerative joint diseases.
23.Imaging of inflammatory bone and joint diseases. Osteomyelitis, arthritis. Aseptic bone necrosis.
24.Imaging of bone metastases. Radiologic and nuclear medicine techniques.
25.Neuroradiology. Imaging techniques and indications.
26.Neuroradiology. Imaging of acute intracranial vascular diseases. Stroke.
27.Imaging in neurotrauma.
28.Imaging of the vertebral column and the spinal cord. Main diseases.
29.Imaging of the head and the neck. Imaging methods, indications and strategy.
30.Imaging of the orbit and the paranasal sinuses. Imaging methods, indications and strategy.
31.Imaging of the breast. Mammography, clinical mammography, ultrasound.
32.Imaging strategy in gynecologic tumors (cervix, uterus, ovarium).
33.Intravascular radiologic interventions I. Methods of revascularization (PTA, stent implantation, selective thrombolysis, catheter thrombectomy/embolectomy).
34.Intravascular radiologic interventions II. Interventional radiologic treatment of bleeding, vasoocclusive techniques (embolization, sclerotisation).
35.Image-guided biopsies. Cyst puncture, drainage (biliary, renal, bladder etc.)
36.Radiologic interventions in tumor treatment (Tumor ablation techniques. Selective cytostatic treatment, chemoembolization).
37.The fundamentals of nuclear medicine imaging. Types of radiation, applications.
38.Advantages of hybrid techniques (SPECT/CT, PET/CT).
39.Radioisotope diagnostics of pulmonary embolism (perfusion and inhalation). Radioisotope methods in pulmonary malignancies.
40.Radioisotope examination of myocardial perfusion (transient and permanent ischaemia, viability). Radioisotope examination of left ventricle pump function and wall motion problems.
41.Radioisotope diagnostics of thyroid diseases and parathyroid diseases.
42.Nuclear medicine methods in childhood (kidney, bone, 123I-MIBG scintigraphy).
43.Radioisotope diagnostics in breast and gynecologic tumors. The significance of sentinel lymph node scintigraphy.
44.Brain perfusion examinations in nuclear medicine (indications, radiopharmaceuticals, imaging).
45.Nuclear medicine examinations in gastroenterology.
46.Isotope renography (indications, radiopharmaceuticals, imaging).
47.Indications of bone scintigraphy. The significance and indications of 3-phase bone scintigraphy.
48.Radioiodine therapy in the diseases of the thyroid gland.
49.Radionuclide therapy of neuroendocrine and neuroectodermal tumors.

Examiners

• Dr. Battyáni István
• Dr. Bódisné Dr. Zámbó Katalin
• Dr. Bogner Péter
• Dr. Faluhelyi Nándor
• Dr. Farkas Orsolya
• Dr. Giyab Omar
• Dr. Horváth László
• Dr. Járay Ákos
• Dr. Molnárné Dr. Szabó Zsuzsanna
• Dr. Rostás Tamás
• Dr. Várady Edit

Instructor / tutor of practices and seminars

• Dr. Bán Zsuzsanna
• Dr. Battyáni István
• Dr. Bódisné Dr. Zámbó Katalin
• Dr. Farkas Orsolya
• Dr. Giyab Omar
• Dr. Járay Ákos
• Dr. Kovács András
• Dr. Molnárné Dr. Szabó Zsuzsanna