Typical First Year Rotation

First Year Training

In parallel with remedial didactic course work, the first year resident will work closely with staff physicists involved in clinical activities within Diagnostic Radiology and Nuclear Medicine. The resident's performance will be evaluated in an ongoing manner by the Director and the three Clinical Coordinators and on at least an annual basis by oral examination. Evaluations of the resident’s performance will be made by the clinical supervisor during each period.  These evaluations will become part of the resident's file. Additional reading assignments may be given to strengthen theoretical understanding of various clinical procedures. The resident will document his or her participation in these activities through an online system and through weekly reports to the Clinical Coordinators and Program Director.

The residency training program will generally commence at the beginning of an academic semester. Residents will participate in the GSBS Introductory Diagnostic Imaging Rotation course as an introduction to the residency program. This will serve as a review of basic imaging principles and clinical applications, as well as to familiarize them with the inventory and operation of clinical imaging equipment at MD Anderson. The following broad areas will be covered during the residency program.

X-ray equipment performance evaluation, acceptance testing and quality control: Performance evaluation of X-ray generators/sources including collimation assessment, focal spot assessment, beam filtration, radiation output, output linearity and reproducibility, technical factor calibration assessment, automatic exposure control and automatic brightness stabilization evaluation (reproducibility, kVp and thickness tracking, density adjustment settings, mechanical and electrical safety.)

Image receptor review: Grid uniformity, system speed consistency, system image quality (contrast, resolution, noise, artifacts), receptor alignment, receptor input exposure rate determination.

Development and monitoring of quality control programs: Processor QC tests, darkroom facility assessment, film-screen contact, , mammographic compression, reading room viewing conditions, repeat/reject analysis, lead apron integrity,  and mammographic phantom image evaluation, S/N ratio, uniformity and artifacts.

Radiation safety surveys: Evaluation of tube head leakage, workload determination, equipment radiation safety features, assessment of auxiliary shielding (e.g., drapes, aprons, and transparent shields), broad beam transmission measurements, personnel monitoring report interpretation, interpretation of regulations.

Patient dose monitoring: In-air measurements of exposure and exposure rates from X-ray equipment and measurements with phantoms using ionization chambers, patient dose measurement using film and other dosimetry devices, calculation of skin entrance dose, internal organ dose, effective dose equivalent, risk estimation, evaluation of potential for deterministic effects, calibration and quality assurance of dosimeters and automated dosimetry systems.

Mammography: Image quality, dose, and system performance evaluations as required by the Mammography Quality Standards Act (MQSA), American College of Radiology (ACR), and the Texas Board of Radiological Health.

Computed tomography: Detector/data channel configurations, image thickness, , helical slice sensitivity profiles (SSPs), high-contrast resolution, low-contrast resolution CT number linearity, image noise and artifacts, reconstruction options, radiation profiles, dose measurements, dose modulation, patient dose calculations, fetal dose estimates, shielding design, monitor luminance measurement, ACR accreditation program.

MRI equipment performance evaluation: Radiofrequency shielding tests, magnetic field homogeneity assessment, signal stability assessment, geometric accuracy, assessment of slice position, slice thickness and spacing, signal-to-noise ratio measurements, RF coil performance tests,  image uniformity assessment, high-contrast resolution and low contrast detectability assessment, testing of high performance imaging and spectroscopy modes, ACR MR Accreditation Program, phantom testing and analysis, MRI safety, image artifacts, protocol and imaging option reviews.

Nuclear medicine/PET: Daily quality control, scanner calibration, image formation, data processing, mage quality, quantitative planar imaging, quantitative PET and SPECT, radionuclide dosimetry and radionuclide therapy treatment planning, non-imaging instrumentation, radiopharmacy operations, site planning and shielding design, installation and acceptance testing of nuclear medicine cameras, radiation exposure of patients, personnel and members of the general public. ACR NM and PET accreditation program phantom testing and analysis, radiation safety, image artifact, troubleshooting as well as physician interpretation.

Ultrasound equipment performance evaluation: Uniformity, depth of penetration, caliper accuracy, axial and lateral spatial resolution, anechoic object assessment, dead zone measurement, artifact assessment, assessment of system mechanical integrity.

Imaging informatics: Configuration and troubleshooting of imaging equipment for connectivity with Picture Archiving and Communications System (PACS), Radiology Information System (RIS), image processing workstations, image review stations, and other network destinations; informatics standards including DICOM 3.0, Health Level 7 (HL7) and Integrating the Healthcare Enterprise (IHE).

Electronic displays: Measurement and assessment of electronic display performance including conformance to DICOM Part 14 Grayscale Display Function (GSDF), AAPM Task Group 18 periodic measurements and acceptance testing for displays for primary interpretation and for clinical review.

Additional experiences: Involvement in discussion of equipment purchase, design of quality control and radiation safety programs, X-ray room shielding design, verification and radiation safety surveys, consultation regarding radiation safety, patient doses and image quality improvement.

Continuing education experiences: First-year residents will have the opportunity to participate in short courses offered by the Department of Imaging Physics. These short courses include topics in Multislice CT, MRI, and PET imaging. Residents who attend the AAPM Annual Meeting are also required to enroll in the Diagnostic Review Course. Residents also attended seminars in the Department of Imaging Physics and are invited to attend the Faculty Mentoring program when they provide continuing education intended for diagnostic medical physicists who are participating in the ABR Maintenance of Certification (MOC) Program.