Medical Imaging & Clinical Research

Radiography is an imaging technique using X-rays to view the internal form of an object. When a beam of X-rays form an electromagnetic radiation, are passed towards the object and then captured by detector behind that object depend on structural composition. The generation of flat two dimensional images by this technique is called projectional radiography. Applications of radiography include medical or "diagnostic" radiography and industrial radiography. Body is made up of various substances with differing densities, X-rays can be used to reveal the internal structure of the body on film by highlighting these differences using attenuation, or the absorption of X-ray photons by the denser substances (like calcium-rich bones).

• Medical use of radiography

• Projectional radiography.

• Computed tomography.

• Dual energy X-ray   absorptiometry.

• Fluoroscopy.

• Contrast radiography.

Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body in both health and disease. MRI scanners use strong magnetic fields, radio waves to generate images of the body. MRI does not use x-rays or ionizing radiations. MRI may still be seen as a better choice than a CT scan. MRI is widely used in hospitals and clinics for medical diagnosis, staging, without using radiations. , MRI scans typically take longer and are louder, and they usually need the subject to enter a narrow, confining tube. In addition, people with some medical implants or other non-removable metal inside the body may be unable to undergo an MRI examination safely.

MRI development in the 1970s and 1980s, MRI has proven to be a highly versatile imaging technique. While MRI is most prominently used in diagnostic medicine and biomedical research, it also may be used to form images of non-living objects. MRI scans are capable of producing a variety of chemical and physical data, in addition to detailed spatial images.

Nuclear medicine is a medical speciality in which disease is diagnosed and treated by the application of radioactive substances. Nuclear medicine, in a sense, is "radiology done inside out" or "endoradiology" because it records radiation emitting from within the body rather than radiation that is generated by external sources like X-rays. Nuclear medicine is also known as physiological imaging modality; because it is differ from radiology (nuclear medicine is not emphasis on imaging anatomy).Single photon emission computed tomography (SPECT) and positron emission tomography (PET) scans are the two most common imaging modalities in nuclear medicine.

In nuclear medicine procedure, patient will inhale, swallow, or being injected with a radiopharmaceutical (radioactive material) after taking it patient will lie and external detectors (gamma cameras) capture and form an images from the radiation emitted by that radiopharmaceuticals.

Ultrasonography is also known as diagnostic sonography or medical solography’s a. Ultrasonography application of ultrasounds to form a diagnostic imaging, which is used to see internal body structure such as tendons, muscles, joints blood vessels. Its objective is to find the source of a disease or to exclude any pathology. The practice of examining pregnant women by using ultrasound is known as obestric ultrasound. Widely   used ultrasound sound waves with frequency of   >20,000HZ (higher than those audible to humans).

Ultrasonic images, also known as sonograms, are made by sending pulses of ultrasound into tissue using a probe. The sound echoes off the tissue; with different tissues reflecting varying degrees of sound. These echoes are recorded and displayed as an image to the operator. Different images are formed by sonographc instruments; most well-known image type is a B-mode image, in which acoustic impedance of a two-dimensional cross-section of tissue. Other types of image can display blood flow, motion of tissue over time, the location of blood, the presence of specific molecules, the stiffness of tissue, or the anatomy of a three-dimensional region.

Computed tomography scan, makes use of computer processed combination of many X-ray measurements taken from different angles to produce cross sectional images of specific areas of a scanned object, allowing the user to see inside the object without cutting. Use of CT has increase over the last two decades in many countries. Lower radiation doses are often used in many areas, such as in the investigation of renal colic side effects from intravenous contrast used in some types of studies include kidney problems.

CT is regarded as a moderate- to high-radiation diagnostic technique. The improved resolution of CT has permitted the development of new investigations, which may have advantages; compared to conventional radiography.

Neuroimaging or brain imaging is a technique which is used directly or indirectly image the structure, function/pharmacology of the nervous system, those who are specialised in the neuroimaging is known as neuroradiologists. It is relative to the neuroscience, medicine and psychology.

Neuroimaging falls into two broad categories:

• Structural imaging, which deals with the structure of the nervous system and the diagnosis of gross (large scale) intracranial disease (such as a tumour) and injury.
• Functional imaging, which is used to diagnose metabolic diseases and lesions on a finer scale (such as Alzheimer's disease) and also for neurological and cognitive psychology research and building brain-computer interfaces.

Oncology branch of medicine deals with prevention, diagnosis, and treatment of cancer. A medical professional who practices oncology is an oncologist. The three main divisions in oncology, Medical oncology, surgical oncology, Radiation oncology. Cancers are often managed through discussion on multi-disciplinary cancer conference where medical oncologists, surgical oncologists, radiation oncologists, pathologists, radiologists. Diagnosis and staging investigators depend on the site and type of malignancy.

Cardiac imaging is performed to diagnose diseases of heart. A cardio radiologist performs and then interprets medical imaging to diagnose heart disease, leaky heart valves and defects in size and shape of the heart. Cardiac imaging techniques include coronary catheterization, echocardiogram, Intravascular ultrasound, Cardiac PET scan, Cardiac CT scan and Cardiac MRI.

Coronary catheterization is used to determine the patency and configuration of the coronary artery lumens.

Echocardiogram or Transthoracic echocardiogram uses ultrasonic waves for continuous heart chamber and blood movement visualization.

Intravascular ultrasound is also known as a percutaneous echocardiogram, it is an imaging method specially designed as long, thin, complex manufactured catheters attached to computerized ultrasound equipment to visualize the lumen and the interior wall of blood vessels.

Positron emission tomography (PET) is a imaging methodology for positron emitting radioisotopes. Mostly used for the researches. Appropriate radioisotopes of elements within chemical compounds of the metabolic pathways being examined. 

A coronary CT calcium scan is a computed tomography (CT) scan of heart, for the assement of severity of coronary artery disease.it looks for calcium deposition in coronary arteries, which narrows and increases the risk of heart attack.

Magnetic resonance imaging (MRI) scanning is a imaging methodology, it comprehensive exams including the quantitative assessment of size and morphology, function and tissue characterization in single sessions.

Ophthalmology is a branch of medicine and surgery that deals with the anatomy, physiology and diseases of the eyeball and orbit. An ophthalmologist is a specialist in medical and surgical diseases of eyeball and orbit and may participate in academic research on the diagnosis and treatment for eye disorders. Diagnosis contains an eye examination and specialised tests done by ophthalmologist.

A partial list of most common diseases diagnosed and treated are Cataract, Glaucoma, Macular degeneration, Diabetic retinopathy, Dry eyes,Strabisums,Proptosis,Excessive tearing, Uvelitis, Eye tumours.

Molecular imaging is a new medical discipline that integrates cell biology, molecular biology and diagnostic imaging. Clinical applications include nuclear medicine, magnetic resonance imaging (MRI) and ultrasound (US).In molecular imaging probes which are known as biomarkers are used, those interact chemically with their surroundings and turn alter the image according to molecular changes occurring within the area of interest. This ability to image fine molecular changes opens up an incredible number of exciting possibilities for medical application, including detection and treatment of disease and further more allows for quantitative tests imparting a greater degree of objectivity to the study of these areas. One emerging technology is MALDI molecular imaging based on mass spectrometry.

 Radiation oncology is Subspecialty of oncology concerned with radiotherapy. Radiation oncology is medical speciality concerned with prescribing radiation and is differ from radiology It is also common to combine radiation therapy with surgery, chemotherapy, hormone therapy, immunotherapy or some mixture of the four. Most common cancer types can be treated with radiation therapy in some way.

Radiation therapy or radiotherapy aims at ionizing radiation, generally as a part of cancer treatment to control to kill malignant cells. It may also be used as a part of adjuvant therapy, to prevent tumour recurrence after surgery to remove a primary malignant tumour. Radiation therapy is synergistic with chemotherapy and has been used before, during, and after chemotherapy in susceptible cancers.

Radiation therapy is used to treat early stage Dupuytren's disease and Ledderhose disease. Dupuytren's disease and Ledderhose disease. Radiation therapy is also used post-surgery in some cases to prevent the disease continuing to progress. Low doses of radiation are used typically three gray of radiation for five days, with a break of three months followed by another phase of three gray of radiation for five days.

Pathology imaging is also known as digital pathology, which enabled by the computer technology that allowed for the management of information generated from a digital slide. The field of digital pathology has exploded and is currently regarded as one of the most promising avenues of diagnostic medicine in order to achieve even better, faster and cheaper diagnosis, prognosis and prediction of cancer and other important diseases. In digital pathology, the pathologists take a slide under a microscope which is stained to highlight structures, which are analysed in using computer algorithms. Algorithms may be automated to manual counting and classify the condition of the tissue such as used in grading tumours. Digital pathology is widely used for educational purposes in research projects. Digital pathology in diagnostics is an emerging and upcoming field.

 Medical imaging techniques such as positron emission tomography (PET) and magnetic resonance imaging are routinely used in oncology and neuroscience. For measurement of tumour, shrinkage is a commonly used surrogate endpoint in solid tumour response evaluation. In Alzheimer's disease, MRI scans of the entire brain can accurately assess the rate of hippocampal atrophy , while PET scans can measure the brain's metabolic activity by measuring regional glucose metabolism, and beta-amyloid plaques using tracers such as Pittsburgh compound B (PiB).

In recent years, the field of medical imaging stimulated by advances in digital and communication technologies grown tremendously. New imaging techniques that reveal greater anatomical details are in diagnostic radiology departments. We discuss vascular imaging with ultrasound, high-resolution computed tomography of the thorax, magnetic resonance imaging applications, and picture archiving and communication systems. Magnetic resonance imaging applications for all areas of the body are being investigated and are replacing older roentgen graphic techniques such as computed tomography, arthrography, myelography, and even angiography in a growing number of indications.

The term "clinical research" refers to the entire bibliography of a drug/device/biologic. Clinical research resembles with health care sciences, determines safety and effectiveness of medication, diagnostic products and treatment regimen for human use. These are used for prevention, treatment, diagnosis or for reliving symptoms. Clinical research is different from clinical practice.

Clinical research is often conducted at academic medical centres and affiliated research study sites. These provide the prestige of the academic institution as well as access to larger metropolitan areas, providing a larger pool of medical participants. These academic medical centres often have their internal Institutional Review Boards that oversee the ethical conduct of medical research.

Clinical Trails are experiments or observations done in clinical research, such prospective   or behavioral research studies on human participants are designed to answer specific questions about biomedical or behavioural interventions, including vaccines, drugs, dietary choices, dietary supplements and medical devices and for further study and comparison. Clinical trials generate data on safety and efficacy. They are conducted only after they have received healthy authority/ethic committee approval in the country.  Clinical study design aims to ensure the scientific validity and reproducibility of the results.

Clinical biostatistics is concerned with research into the principles and methodology used in the design and analysis of clinical research and to apply statistical theory to clinical medicine. Clinical data management (CDM) is a generation of high quality, reliable, and statistically sound data from clinical trials. The ultimate goal of CDM is to ensure that conclusions drawn from research are well supported by the data. Achieving this goal protects public health and confidence in marketed therapeutics.

Medical writing is established in pharmaceutical industry, because it requires special skill to produce well-structured documents hat present information clearly and concisely. Medical writing for pharmaceutical industry can be classified as either regulatory medical writing or educational medical writing. Regulatory medical writing means creating the documentation that regulatory, which include clinical protocols, clinical study reports, patients informed consent forms, investigator broachers and summary documents.

Educational medical writings mean writing documents about drugs, devices and biologics for healthcare professionals. These contain sales literature for newly launched drugs and data presentations at conferences.

A case report on Cardiology gives an appropriate convention for all cardiologists by rendering their important clinical cases of late occurrence. Studying from medical cases provides valuable information for the students and Paramedical researchers.

Acute coronary syndromes (ACS) are a broad term referring to a group of conditions ranging from unstable angina, to myocardial infarction (heart attack), to sudden cardiac death. The condition depends on the degree to which the coronary artery has been obstructed and the health effects the obstruction has caused. A diagnosis of ACS is made by evaluating the results of an electrocardiogram (ECG) and the presence or absence of certain enzymes in the body.

Preclinical research is also named as preclinical development or non-clinical studies. In drug development it is a stage of research, performed before clinical trials can begin and during which is important feasibility, iterative testing and drug safety data are collected. Its main aim is to determine the safe dose for first in man study and should assess a products safety profile. Only one in every 5,000 compounds that enter drug discovery to the stage of preclinical development gets approved.

Each class of product should undergo preclinical research, for intensive it should undergo pharmacodynamics (what the drug does to the body), pharmacokinetics (what the body does to the drug), ADME (absorption, distribution, metabolism, excretion) and toxicology testing. Typically, both in vitro and in vivo tests will be performed. Studies of a drug's toxicity include which organs are targeted by that drug, as well as if there are any long-term carcinogenic effects.

These are clinical trials performed after pre-clinical trials. Clinical trials involving new drugs are commonly classified into five phases; each phase of drug approval is treated as separate clinical trial. If the drug passes through phases 1, 2 and 3 it approved by the national regulatory authority for use of general population.

Phase 0: It aims at Pharmacodynamics and Pharmacokinetics in human, which are optional first in human trails. For study or treatment sub therapeutic dose given to small.

Phase 1: It is a screening of safety, to identify the safe dosage and side effects when trial is often first in human (testing with small group). But it is not accepted (because a drug side effect may be subtle or long term).

Phase 2: It aims at efficiency of the drug, it tested and a large group of people because it shows low common side effects.

Phase 3: It’s a final conformational of safety and side effects. It tested on large groups to conform its efficiency and to evaluate effectiveness and to monitor side effects, comparing to normally used treatment.

Phase 4: It is a safety study during sale; it is a post marketing studies, which adds additional information. It gives treatment risks, benefits, and optimal use.

A case report is a detailed report of the symptoms, signs, diagnosis treatment of a patient on the basis of the clinical trial.  Some case reports are professional narratives that provide feedback on clinical guidelines and offer a framework for early signs of effectiveness, adverse events and cost. Some of case reports are as unique or rare features of diseases, an unexpected association between diseases or symptoms. A case report is generally considered a type of anecdotal evidence. The case report can detail many aspects of the patient.