Many of the greatest inventions in the modern medical device industry were imported from physics research. X-Rays, nuclear magnetic resonance imaging (MRI), ultrasound, radioisotope tagging and detection techniques are among many contributions of physics to medical diagnostics. This amounts to more than 50 years of advancement in diagnostic medical physics and a revolution in medical practice.
The distinction between imaging and therapy have been blurring in recent years, as have the roles of medical physicists and physicians. Often the same processes are used for imaging, then used in modified form for treatment. The medical physicist has evolved into a specific healthcare profession. Most are employed in the hospital’s diagnostic and intervention radiology department or medical imaging departments. In some countries, they may be employed in clinical physiology departments, neurophysiology, radiation protection, or audiology departments.
Departments of Radiation Physics, such as the department at the University of Texas, offer post-graduate degrees (MA and PhD degrees). Two-year residency programs are available at Yale University’s Department of Therapeutic Radiology. Yale’s program leads to a certification in Therapeutic Medical Physics examination through the American Board of Radiology.
Three-dimensional imaging is vital in the diagnosis of body abnormalities and the preparation for therapy. Much of modern medicine relies on imaging from Magnetic Resonance scanners or computer tomography that combines high-resolution X-rays to make 3D images out of 2D images. Recent developments have resulted in very high-resolution computer tomography (CT) scanning. New CT scanners can take five slice volumes per second, enough to make moving 3D images of a beating heart.
New diffusion imaging techniques can show the way water is diffused throughout the body. This enables the visualization of soft tissue like nerve bundles and muscle fibers. New imaging techniques work at the submicroscopic level, the level of molecules and genes. These images using electron microscopy and other technologies can reveal pathologies before they become apparent on a larger scale.
The images can now be presented to surgeons and other professionals in spectacular style using 3D technologies and virtual reality so that doctors can move through the image to examine details. Reconstructive surgery especially benefits from high-resolution 3D imaging.
High Intensity Ultrasound (HIFU) is a relatively new kind of cancer treatment. Ultrasound is commonly used to observe blood clots and tumors in a less invasive way. Similar instruments are used to treat malignant cells by focusing intense (large wave amplitude) beams of mechanical waves at a frequency above human hearing sensitivity at target cancer cells.
The mechanical waves kill some cells when the beam is focused on them. This kind of treatment has fewer side effects than radiation or chemotherapy treatments. HIFU is only useful to treat a single tumor or a large tumor. It is not useful for aggressive and widely spread tumors. Bones and air space in the body leave shadows in mechanical wave transmission. HIFU is not useful for treatment of cancers blocked by bone or air space.
Medical Nanotechology is in early stages of development. In a passive form, in products like sunscreens and cosmetics, tailored chemical molecules are providing light filtration functions. Smart drugs are molecular constructions that can target the release of medications to particular areas of the body, bypassing the body’s natural distribution. Organic-like molecular structures are being developed that can could be the basis of organ reconstruction.
Administering Isotopes via Catheters allows more precise positioning of radiaton. New devices (the patent application dated on 1999) are being used to deliver radiation directly to intramuscular tumor sites. “Central Venomous Catheters” (CVCs) have been used to place isotope tracers into key organ systems to allow for monitoring of treatment or disease progression. The organ outflows are monitored with sensitive gamma ray counters to plot the organ’s function. Results can also be assessed with blood tests that measure the presence of the gamma rays.
More Established Technologies:
In the last 50 years, radio isotope manufacturing using particle accelerators (cyclotrons) has given cancer treatment an important new tool for eliminating tumors and cancer cell accumulations. Linear accelerators have been established in medical settings for delivering high energy electron beams or x-ray beams to malignant tissue.
More recently, intensity-modulated radiation therapy (IMRT) has enhanced the ability of radiation beams to control tumors. Computers are employed to precisely aim and shape the radiation treatment field and control the accelerator beam. This precision control delivers a maximum amount of radiation to the growth, while minimizing the radiation on surrounding tissue. IMRT is used for treating many inoperable cancers, prostrate cancer, brain cancers, head and neck malignancies in both children and adults.
Breast cancer screening imaging has seen many advances. Film is widely replaced with more sensitive digital imaging which can be transmitted through a network. Newer techniques have reduced the level of radiation to the patient. The sensitivity of the images has improved leading to greater ability to find early and treatable disease. Computer-aided and enhanced imaging (like CT scans) and the use of MRIs for breast cancer screening promise further precision in detecting and locating breast cancer in younger women and earlier stages.
Positron Emission Tomography (PET) techniques use short-lived radionuclides produced in cyclotrons. These short-lived particles decay and emit positrons (the anti-matter equivalent of electrons). The anti-matter electrons collide with electrons annihilating both and producing pairs of photons that are captured to produce an image.
Positrons are labeled to compounds such as glucose, testosterone and amino acids. Precise measures of radionuclides can monitor physiological processes like blood flow and glucose metabolism allowing visual imaging that can predict seizures, coronary heart disease, and ischemia. PET imaging is used to detect tumors and monitor the progress of treatment.
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