GLOSSARY OF TERMS USING IMAGE MANUAL

TRAINING FOR ICON MEDICAL IMAGING

Note: each IMT (Image Manual Training) teleconference is split into sections, the main topics
covered being:
(1) Trial Overview - to describe the aim of the trial
(2) Imaging schedule - , to describe when patient exams are to be performed
(3) Parameters - to explain which imaging modalities (eg CT, MRI) should be used and any
specific scanning parameters which must be observed
(4) Submission - to explain how the images should be submitted plus an overview of the
electronic method (eg AGMednet, Medidata, SFPT)
(5) Query Resolution or how to respond to queries sent out by ICON Plc using their proprietary
web-based system ‘SQUARE’.

2 chamber view: cardiac view demonstrated by MRI or ultrasound of left ventricle and atrium.
2D: MRI scans may be 2-dimensionsal or 3 dimensional.
3 chamber view: cardiac view demonstrated by MRI or ultrasound of left ventricle, aorta and
atrium.
3D: MRI scans may be 2-dimensionsal or 3 dimensional.
4 chamber view: cardiac view demonstrated by MRI or ultrasound of all ventricles and atria.
5 chamber view: cardiac view demonstrated by ultrasound of all ventricles, atria and aorta.
A2C: apical 2 chamber view – cardiac ultrasound view.
A3C: apical 3 chamber view – cardiac ultrasound view.
A4C: apical 4 chamber view – cardiac ultrasound view.
A5C: apical 5 chamber view – cardiac ultrasound view.
Adjuvant treatment: the main drug treatment, taken after any neo-adjuvant treatment used to
reduce the lesion.
AGMednet: A form of electronic image submission; if required it will be fully explained by the
imaging specialist during training.
Algorithm: in imaging, the type of display: standard algorithm shows all tissue, but in CT lung
windows or bone windows may be selected.
Annulus: ring-shaped anatomical structure as in an intervertebral disc or the tricuspid valve of
the heart.
Antero-posterior: view taken during x-ray examination (front to back).
Aorta: Main artery carrying oxygenated blood from the heart.
Aortic valve: Heart valve between the left ventricle and the aorta.
AP: see Antero-posterior.
Apex of chest: the uppermost parts of the lungs and ribs.
Apex of heart: the tip of the heart made by the inferior boundaries of the ventricles.
Apical chamber views: cardiac ultrasound views, may be 3 or 4 chambers (A3C, A4C or even
five (A5C) if aorta is included).
Artifact: outside influences which may degrade the image; eg patient movement or metal
implants.

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Atrium: Chamber of the heart.
Axial: A scan direction or ‘plane’, anatomy is scanned cross-sectionally.
Baseline: The first scan of a subject which acts as a control to evaluate the efficacy of the
drug.
Bone Mineral Density – or BMD, a quantitative measurement of the bone density to give an
indication of osteoporosis.
Bone window: In CT, an adjustment to the image view so that bone is highlighted.
C-flow: see Colour flow.
Chamber: ventricle or atrium of heart.
Chamber view – scans of the chambers of the heart (ultrasound or MRI). Can be 2,3 or 4
chamber views; in cardiac ultrasound there may be a 5-chamber view if aorta is included.
CoE – see Confirmation of Eligibility.
Colour flow: specialized ultrasound technique.
Complete response: when the disease is removed by the drug.
Confirmation of Eligibility: Or CoE, confirmation that a subject meets the criteria for inclusion
in the trial.
Confirmation of Progression: or CoP: in many trials ICON can be asked to confirm if a
cancer has progressed. Identical to Verification of Progression (VoP).
Contiguous slices: see Slice gap. No gap between slices.
Continuous wave Doppler: specialized ultrasound technique.
Contraindication: A reason a scan cannot be performed, e.g. allergy to contrast.
Contrast: Or ‘contrast agent’. Name for dye used in radiology.
CoP: see Confirmation of progression.
Coronal: A scan direction or ‘plane’, anatomy is scanned left to right.
Cycles: The periods of time between each dose of the drug.
Data Transmittal Form: Or DTF – form which is sent by the site to accompany their
submissions. This will be fully explained by the imaging specialist during training.
DEXA: 0r DXA, dual energy x-ray attenuation, a type of x-ray examination looking at bone
mineral density for possible osteoporosis.
Diastole: period in the heartbeat cycle when the muscles relax.
DICOM: Digital Imaging and Communications in Medicine, a format used for storing and
transmitting image data and is requisite for most submissions to ICON.
Dixon: A type of MRI sequence used in abdominal work.
Diffusion Tensor Imaging: specialized brain MRI scan demonstrating white brain fibers.
Diffusion Weighted Imaging: Or DWI. A specialized type of MRI scan.
Doppler: Ultrasound technique for demonstrating blood flow.
Dose date: The date on which a dose of drug is given.
DTF: see Data Transmittal Form.
DTI: see Diffusion Tensor Imaging
DXA: or DEXA, dual energy x-ray attenuation, a type of x-ray examination looking at bone
mineral density for possible osteoporosis.
Early termination: when a subject leaves the trial before its completion for whatever reason.
Eligibility scan: A scan performed to see of the subject fits the criteria of the trial.
End of Treatment: The time when, for whatever reason, the patients ceases to be given the
drug.
Fast spin echo: type of MRI sequence.
Fat saturation: Some scans require the suppression of fat tissue. They are called ‘fat

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 saturation sequences, or ‘FS’ or ‘fatsat’.
Fatsat – see fat saturation.
FDG – see fluorodeoxyglucose.
FLAIR: usually pronounced as one word ‘flair’, specialized brain sequence which suppresses
water signal.
Flip angle: Technical term donating angle at which the MR signal is turned during a scan.
Fluorodeoxyglucose: FDG is the tracer used in PET imaging and is tagged to the required
tissue.
FOV: Field of view, the amount of anatomy included in the scan.
FS – see fat saturation.
FSE – see fast spin echo.
Gadolinium: The contrast or dye used in MRI.
Gallium: an isotope commonly used in nuclear medicine.
Gamma rays: a penetrating electromagnetic radiation arising from the radioactive decay of
atomic nuclei; detected during nuclear medicine scans.
GE – see gradient echo.
Gradient echo: Type of MR sequence also known as T2*, ‘GE’ or ‘GRE’.
GRE – see gradient echo.
Imaging schedule: The timetable to demonstrate when each submission is due.
In phase: MRI technique where fat and water are both in phase and signals are received from
both.
Inferior vena cava: Or IVC - major vein carrying blood to the right atrium of the heart.
Investigational product: The drug being tested.
Iodine: Main constituent of x-ray / CT contrast; the injection is contraindicated in cases of
allergy.
IR: Inversion recovery, type of MRI sequence.
IV: Intravenous – injection.
IVC: see Inferior vena cava.
Lateral: viewed from the side.
Left ventricular outflow tract – the pathway of blood through the ventricle and into the aorta.
Lung window: In CT, an adjustment to the image so that lung tissue is highlighted.
LVOT: see Left ventricular outflow tract.
M-mode: or ‘motion mode’, ultrasound technique to evaluate motion and timing.
Medidata: A form of electronic image submission; if required it will be fully explained by the
imaging specialist during training. Also knowns as RAVE.
Mitral valve: heart valve lying between the left ventricle and atrium.
Modality: type of imaging equipment/examination e.g. MRI, CT, ultrasound, nuclear medicine
etc.
MRA: Magnetic Resonance Angiography, MRI used for depicting blood vessels.
MRE: Magnetic resonance elastography, an MRI technique for evaluating liver stiffness.
MRI: Magnetic Resonance Imaging or simply MR.
Multi Echo: MRI sequence used in NASH trials.
MV: see Mitral valve.
My Signature Book: This will be explained during training. An electronic signature tool that is
used
to confirm the attendee was at the meeting.
NASH: Non-alcoholic steatohepatitis. Condition examined for a number of trials.

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Neo-adjuvant treatment: preliminary treatment of a tumor to reduce its size before continuing
onto the main or adjuvant treatment.
NEX: Often pronounced as one word ‘nex’, number of excitations, an MRI parameter.
NM: Nuclear medicine
Nuclear medicine: use of injected radioisotope to track abnormal uptake in diseased tissues;
this emits gamma-rays which are collected and imaged.
ODQ: Outstanding Data Query – sent out if expected submission has not arrived.
Osteopaenia: low bone density with T score of less than -1.0 and -2.5 on DEXA. Not as severe
as osteoporosis.
Osteoporosis: low bone density with T score of less than -2.5 on DEXA.
Out of phase: MRI technique where fat and water are out of phase and signals are received
from water only.
PA: see Postero-anterior.
PA: see Pulmonary artery.
Papillary muscles: heart muscles attached to the mitral and tricuspid valves.
Parameters: The individual settings for each scan.
Parasternal Long Axis View: or PLAX. Cardiac ultrasound view.
Parasternal Short Axis View: or PSAX. Cardiac ultrasound view.
Partial response: When the extent disease is reduced in some degree.
Partial wave Doppler: specialized ultrasound technique.
Perfusion: A specialized type of MRI, mostly brain work.
PET – see Positron emission tomography
PET / CT: PET performed simultaneously with CT; the resulting images can be fused to give
both pathological and anatomical information.
Phantom: An object scanned before the site can examine patients, to ensure the sequences
are correct.
Plane: the direction in which a scan takes place, e.g. horizontally.
PLAX: see Parasternal Long Axis View.
Positron emission tomography: or PET, PT; a method of observing metabolic activity as a
guide to lesion diagnosis.
Post-contrast: Scans performed after dye is injected.
Postero-anterior: view taken during x-ray examination (back to front).
Pre-contrast: Scans performed before dye is injected.
Progression of disease: when the condition worsens.
Prone: lying on the stomach.
PSAX: see Parasternal Short Axis View.
PT – see Positron emission tomography
PT / CT – see PET / CT.
Pulmonary artery: carries deoxygenated blood from the right ventricle to the lung.
QC: quality control. Each submission is examined for quality by the imaging specialist.
Randomization: The official time at which a patient enters the trial.
RAVE: see Medidata.
Right ventricular outflow tract – the pathway of blood through the right ventricle and into the
pulmonary artery.
RVOT: see Right ventricular outflow tract
Sagittal: A scan direction or ‘plane’, anatomy is scanned front to back.
Screening: The first scan of a subject to see if he/she is eligible. Usually the same as

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 ‘baseline’.
SE – see spin echo.
SFTP: A form of image submission; if required it will be fully explained by the imaging
specialist during training.
Single-photon emission computed tomography: or SPECT, a type of nuclear medicine scan
capable of also giving 3D information.
Slice: Each MRI/CT scan is composed of a number of cross-sectional areas, or ‘slices’,
through the anatomy.
Slice gap: A gap can also be set between slices. Contiguous slices means no gap.
Slice thickness: The slices can be set at a chosen thickness.
SPECT – see Single-photon emission computed tomography.
Spin echo: A standard type of MRI sequence, aka SE.
SQUARE: Site Query and Resolution Environment. This will be fully explained by the imaging
specialist during training. A web-based site for query resolution.
SSFFE: Steady state fast field echo – MRI sequence used often in NASH studies.
STIR: Usually pronounced as one word, ‘stir’. A type of MRI sequence which suppresses fat
signal.
Supine: lying on the back.
Susceptibility Weighted Imaging: a specialized MRI brain technique.
SWI – see Susceptibility Weighted Imaging.
Systole: period in the heartbeat cycle when the muscles contract and so pump blood.
T: Stands for ‘tesla’ and is a measure of magnet strength. Most MRI scanners are 1.5T or 3T.
T score: In DEXA, is a comparison of a person's bone density with that of a healthy 30-year-
old of the same sex.
T1: Basic MRI sequence.
T1-weighted: MRI sequence designed to give typical T1 appearances.
T2 : Basic MRI sequence.
T2-weighted: MRI sequence designed to give typical T2 appearances.
T2*: MRI sequence; pronounced ‘T – two – star’; type of MRI sequence also known as
‘gradient echo’.
TAPSE: see Tricuspid Annular Plane Systolic Excursion.
TE: MRI. ‘Time of Echo’ usually known as echo time.
Time of flight: An MRI technique for imaging blood vessels.
TR: MRI. ‘Time of Repetition’ usually known as repetition time.
TR: See Tricuspid regurgitation
Tracer: substance used in PET imaging which is tagged to the required tissue.
Tricuspid Annular Plane Systolic Excursion: Or TAPSE, ultrasound measurement of the
movement of the tricuspid ring (annulus) during hearbeat.
Tricuspid regurgitation: reflux of blood back from the right ventricle into the atrium caused by
a weak valve.
Tricuspid valve: heart valve between right ventricle and atrium.
TSE – see turbo spin echo.
Turbo spin echo – MRI sequence, a kind of fast ‘spin echo’.
US: Ultrasound
Ventricle: Chamber of the heart
Verification of Progression: or VOP: in many trials ICON can be asked to verify if a cancer
has

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 progressed.
VoP - see Verification of Progression.
VoP form: A form to be submitted with a submission that needs a VOP assessment.
Waiver form: to confirm that a requested procedure cannot be performed; eg a site may need
to complete a waiver form if they do not wish to use electronic submission but prefer to send
CD by courier.
WHISPER: A form of electronic image submission; if required it will be fully explained by the
imaging specialist during training. (Web Hosted Image Submission Portal with Encrypted Re-
encoding)
Z score: In DEXA, a comparison of a person's bone density with that of an average person of
the same age and sex.