RADIOLOGY IN THE

SERVICE OF HUMANS
Objectives (Competencies- RD 1.2)

1. Describe the evolution of Radiodiagnosis.

2. Identify various radiological equipments In the current era

“THE PRE-RADIOLOGY
ERA”
ANCIENT MEDICAL PRACTICE WAS BASED ON A LOT OF ASSUMPTIONS AND
SUPERSTITIONS…….
THEN CAME THE ERA OF CLINICAL DIAGNOSIS….

…. the diagnosis of disease depended

on the clinical skills of the doctor

The clinicians had no clue to the

processes going on inside the body…..
….EXCEPT BY OPEN SURGICAL MEANS
…IT WAS THEN THAT LENNAC CAME WITH HIS
INVENTION OF THE STETHOSCOPE IN 1816 …

…..BUT THERE WAS NO ACTUAL WAY OF

‘LOOKING INTO THE BODY’
Arthur Goodspeed (1860–1943) William N. Jennings (1860–1945)

22 February 1890 they produced, completely accidentally, an X-ray picture, but were unable to work out
what they had done and the significance of their findings were over-looked !!!!
 Wilhelm Conrad Roentgen
1895, This room changed the way doctors looked at disease - The German physicist

Laboratory at the University of Wurzburg, Germany

He named the radiation ‘X-rays’
 Bertha Roentgen’s
hand

The first ever documented X-ray obtained on 22 December 1895…

He was awarded the First Nobel prize in physics in 1901
Early X-rays

First American Medical X-ray 3

February 1896
"First radiograph of human brain"
H.A. Falk 1896
 X-Ray Tubes
– High-energy electromagnetic waves
– Much the same way as a camera exposes film
PRESENT DAY XRAYS…..
..SUFFERED FROM LUNG
CANCER
NORMAL CHEST RADIOGRAPH LUNG MALIGNANCY
A STILL FROM THE MOVIE ANAND….

The title character is suffering from lymphosarcoma of the intestine

?
 The next major advance in the
field of radiology was the
development of barium
particles for the evaluation of
the Gastro-Intestinal tract

Dr. Walter B. Cannon

Experiments in 1897-1898 with bismuth and barium mixtures

When fed to geese and other animals, outlined gullet on x-ray plate
NORMAL ABNORMAL
FLUOROSCOPY LAB AND
EQUIPEMENTS
GASTRIC ULCER SMALL BOWEL MASS
Emilia suffered an anuerysm at the end of her first season of
Game Of Thrones
 ANGIOGRAPHY

The radiographic visualization of the internal

anatomy of the blood vessels after the
intravascular introduction of radiopaque contrast
medium
Sven-Ivar Seldinger, the
world-renowned Swedish
pioneer in angiography

In 1953, Sven Ivar Seldinger

published a method for
percutaneous arterial
catheterisation that opened the
doors to the field of angiography
& interventional radiology
1 st Angiography
Post-mortem injection of mercury
compounds January 1896
ANGIOGRAPHY SUITE
CORONARY ANGIOGRAPHY
ABDOMINAL AORTOGRAM
KYLIE MINOGUE – THE WORLD RENOUNED POP SINGER
….was diagnosed with breast cancer
 EARLY MAMMOGRAPHY MACHINES….

A patient in Dr Gilbert Baum's early breast scanner undergoing ultrasound

mammography.
Modern Mammography Equipment
 THE FIRST ULTRASOUND MACHINE……….

George D. Ludwig, and his first ultrasonic scanning equipment. Dr Ludwig and
colleagues conducted experiments for the US Navy in the diagnostic capabilities of
ultrasound
Stauffer Lehman, MD, scans a
patient at his laboratory at
Hahnemann Hospital in
Philadelphia, Pennsylvania, in the
early 1960s. Dr Lehman's
laboratory was an important center
for work in the clinical application
of ultrasound in the diagnosis of
abdominal and pelvic diseases in
the United States
The first commercial model of a
portable compound contact
scanner was marketed by
Physionic Engineering, Inc, as
the Porta-arm Scanner

Ultrasound machines today....

Transducers
 3D ULTRASOUND

3D ultrasound from week 28 of pregnancy and one of the baby’s newborn’s pictures
ULTRASOUND-GUIDED BIOPSY
Ultrasound shows a solid mass in
a breast
Ultrasound-guided biopsy of a solid
breast mass shows biopsy needle
about to enter the mass.

Ultrasound-guided biopsy of a
solid breast mass shows
biopsy needle has passed
through the mass.
CHRISTIAN DOPPLER 1843

“A Change in the perceived

frequency of sound emitted
by moving source” – Doppler
Shift
PRESENT DAY DOPPLER MACHINE…..
COLOR DUPLEX SCAN
IVUS SHOWING ATHEROSCLEROTIC STENOSIS OF THE
CORONARY ARTERY
INTRA OPERATIVE USG
COMPUTED TOMOGRAPHY
SIR GODFREY HOUNSFIELD

1972 Sir Godfrey

Hounsfield, EMI Ltd.
demonstrated CT at
Annual congress of the
British Institute of
Radiology
The radiographic examination
displayed as thin tomographic
images representing computer-
assisted mathematic
reconstructions of body tissues
and contents
HOUNSFIELD’s
EARLY CT
SCANNER
1975 - 128 x 128 Today
matrix
CT SCANNER
CT HEAD
CT THORAX
CT ABDOMEN
BETTER 3D IMAGES
3D RECONSTRUCTION OF FRACTURES
 3D-CT of the Abdominal aorta and
Renal arteries

CT ANGIOGRAPHY
ABDOMINAL AORTIC
ANEURYSM
CTA - ANEURYSMS IN BOTH MCA

CTA - ANEURYSM IN THE BASILAR ARTERY

CT CORONARY ANGIOGRAPHY
3D RECONSTRUCTION IMAGE
OF THE CAROTID ARTERIES
(CTA) SHOWING STENT IN
RIGHT CAROTID
OPTICAL COLONOSCOPY AND VIRTUAL
VIEWS OF COLONIC DIVERTICULA
Diverticula are the out-pouchings of the
inner lining of the intestine at the spots
where the muscle walls of the intestine are
the weakest. These diverticula do not have
a muscular coat

CONVENTIONAL AND VIRTUAL

COLONOSCOPY IMAGES OF
PEDUNCULATED POLYP
VIRTUAL COLONOSCOPY
 CT Colonography / Virtual Colonoscopy

• CT colonography uses computed tomography scanning to obtain an

interior view of the colon that can ordinarily only be seen with an
endoscope inserted into the rectum.

• Minimally invasive and provides 3D images that can depict many

polyps and other lesions as clearly as when they are directly seen by
optical colonoscopy
VIRTUAL COLONOSCOPY IMAGES OF PEDUNCULATED POLYP
 India's pace spearhead since the
retirement of all rounder Kapil Dev in
1994. India's most successful one-day
bowler, and second best among fast
bowlers in tests behind Kapil's record
434 victims.

1997 - Suffered a nearly career-

ending rotator cuff tear in his
bowling shoulder and was
sidelined for eight months

Javagal Srinath
Normal Rotator Cuff Tear
 MRI - A BRIEF HISTORY.....

1938 – Rabi – Coined the term NMR

1946 – Bloch and Purcell independently
discovered the MR phenomenon
1973 – Lauterber first created MRI images of two
tubes
1974 – Damadian - image of rat tumour
1978 – First machine by Philips
2003 – Nobel Prize awarded to Paul Lauterber and
Peter Mansfield
Paul Lauterber and Peter Mansfield
PRESENT DAY MRI MACHINES....
OPERATING CONSOLE
 Dhirubhai Ambani expired on
Saturday July 6, 2002, aged 69
yrs, at Mumbai’s Breach Candy
Hospital where he had been
admitted after he suffered a
vascular stroke.
This was his second stroke –
the first had occurred more
than sixteen years earlier, in
February 1986, leaving the
right side of his body paralysed.

Dhirubhai Ambani, founder of the Reliance Group of Industries

Diffusion Weighted Image Diffusion Weighted EPI image
Demonstrating an Infarct Showing Recent Infarct
 Ronald Wilson Reagan, died
at the age of ninety-three
years in California after
suffering from Alzheimer's
disease for the last ten
years

The fortieth President of the

United States of America President
Ronald Reagan
NORMAL AGING Alzheimer's dementia
PET IMAGES, SHOWING BRAIN OF PATIENT WITH ALZHEIMER'S DISEASE

Brain imaging using PET can confirm a diagnosis as patients with Alzheimer's
will typically show a reduction in glucose use in the cerebral cortex - the thin,
outermost layer of the brain responsible for many complex brain functions
including memory, language and consciousness
 PET IMAGES, SHOWING HEATHLY PATIENT'S BRAIN

This scan is from a healthy 70 year old control patient. The fdg scan looks typical
for the age with a good cortical signal (that is in the outer rim of this transverse
section through the brain).
 PET Scanning

• Positron Emission Tomography (PET) is used to look at how

the body uses substances such as glucose, ammonia, water
and oxygen. Seeing how these molecules move through the
body, and where they are being used, allows the doctor to
check for anything unusual that might suggest the
presence of disease.
• By tracking how the body uses glucose, a PET scan can
produce images of cancerous tumours and help the doctor
work out what treatment is best. The body uses glucose for
energy. So cancerous tissue, which uses more glucose than
normal body tissue, will show up as a bright area on the
PET image.
• The most common radiopharmaceutical or tracer used in clinical PET
imaging is 2-18F-deoxy-D-glucose (FDG). This is transported into the
cell like normal glucose, but cannot be metabolised after initial
metabolism, and is trapped within the cell. The greater the uptake of
the FDG in the cell, the more metabolically active it is.
Eg: Cancers and inflammatory diseases
DR.DAVID E. KUHL - 'FATHER' OF PET SCANNING
EARLY PET SCANNER….
PRESENT DAY PET SCANNERS
 PET IMAGES, SHOWING BRAIN TUMOUR

PET scans are useful for identifying tumours because they use more energy,
and therefore glucose, than normal tissue. The FDG tracer, occurs in higher
quantities at the tumour site and this shows up as a bright area on the PET
image.
 PET/ CT

CT PET

FUSION IMAGE
Gone are the old days
The Computerised radiography Process

Cassette is exposed ADC converter processing Interpretation

THANK YOU