As The Christie has played such an important part in developing radiography we are very proud to celebrate World Radiography Day - Rebekah Pearce

Rebekah Pearce - Christie Radiotherapist

Rebekah Pearce

World Radiography Day is celebrated on 8th November each year. Held annually, it provides an opportunity for radiographers worldwide to celebrate their profession, its importance within patient care, to promote the career to future students and increase public awareness of diagnostic imaging and radiation therapy.

So what is a radiographer and what do we do?

There are two different professions that share the umbrella term of ‘radiographer’ – diagnostic radiographer and a therapy radiographer. A diagnostic radiographer helps to diagnose any disease or condition and monitor internal changes. This is vital in diagnosing cancer and we have some very high tech facilities available at The Christie.

A diagnostic radiographer may use X-rays to look at bone anatomy assessment and cavity changes, to check if a bone is broken and if there are any foreign objects in the lung cavity; or they may use fluoroscopy to look at real-time images of the digestive system. Radiographers also use MRI and CT scans to build up two and three dimensional maps of body tissue; and angiography can be used to assess blood vessels. Ultrasound, most commonly used for checking the development of a baby during pregnancy, also has important applications at The Christie.

Therapeutic radiographers, or as they are better known, radiotherapists, work within the hospital oncology department. They use radiation to treat many different forms of cancer all around the body. This includes conventional External Beam Radiotherapy (EBRT) delivered by multi-beam treatments; brachytherapy where the radiation source is placed directly in the affected area; and stereotactic radiotherapy that allows small inoperable tumours to be treated in high dosages. 

For both types of radiographer, their knowledge base must include extensive understanding about the usage of high tech equipment, radiation dosages, pathology, anatomy and physiology of the human body. Moreover, the radiographer must have a caring personality. 

As The Christie has played such an important part in developing radiography over the years we are very proud to celebrate World Radiography Day and the vital work done by all radiographers around the world.

In 1901, The Christie was one of the first places to use X rays to treat cancer and in 1932 we developed the first international standards in radiation treatment – the Manchester Method. More recently, in 2002 we were the first place in the world to use image guided radiotherapy.

World Radiography Day is celebrated on 8 November to mark the anniversary of the discovery of x-radiation by Wilhelm Roentgen in 1895. Wilhelm experimented with passing an electrical current through a low-pressured gas which culminated in discovering and producing an electromagnetic radiation in the wavelength range now known as x-rays. 

He noticed that a number of objects could be penetrated by these rays, and that the projected image of his own hand showed a contrast between the opaque bones and the translucent flesh. This work resulted in him winning the Nobel Prize in physics.

He later used a photographic plate instead of a screen, and an image was captured. In this way, an extraordinary discovery had been made: that the internal structures of the body could be made visible without the necessity of surgery.

As World Radiography Day was on Sunday we decided to celebrate it in the hospital today with an information stand on display in the radiotherapy department with details about radiotherapy, how it works, how treatment is planned and examples of machinery.

Have you thought about a career as a therapy radiographer working in radiotherapy? If you are interested in finding out more details, please email RTEducation@christie.nhs.uk

The gamma camera is making a big difference to the diagnosis and treatment of many Christie patients - David Hamiliton

David Hamiliton - Consultant Clinical Scientist and Group Leader in Nuclear Medicine

David Hamilton

Patients at The Christie are now benefitting from a state-of-the art gamma camera, thanks to the generosity of dozens of dedicated Christie supporters.

I am delighted to have been part of the Nuclear Medicine team which has delivered this exciting project and which seems to have really captured the support of many of our hard working fundraisers.

So, it was with great pleasure that we were able to invite many of our gamma camera fundraisers to a unique behind the scenes tour of the new facilities in the Nuclear Medicine department.

They were welcomed by our Chief Executive, Roger Spencer, and were given a presentation by Dr Prakash Manoharan, Clinical Lead, who explained how important their contribution will be for the pioneering work being undertaken in the department and with The University of Manchester.

The staff in the Nuclear Medicine department have been overwhelmed by the enthusiasm with which fundraisers have supported this project and were delighted to demonstrate for them the equipment that they have provided.

Nuclear medicine is a branch of radiology which produces images of radioactive pharmaceuticals that have been injected into the patient. These show function in different parts of the body rather than anatomy and are therefore very sensitive to changes caused by disease.

A gamma camera detects the gamma photon emissions from the radiopharmaceuticals which clearly reveal abnormal areas, including tumours.

This state-of-the art camera at The Christie will help us give patients a better diagnosis and better understanding of the staging of their cancer. We also have exciting plans to use it to provide better therapy in the future.

The gamma camera is a SPECT camera, which stands for Single Photon Emission Computed Tomography.

Just like in radiology, the patient does not feel the gamma photon emissions that are coming from their body, but the images they create clearly show the processes going on inside the body.

The individual areas that accumulate the radiopharmaceuticals can be very difficult to identify precisely, and the gamma camera incorporates a diagnostic quality CT scanner to overcome this.

The SPECT and the CT images are fused together by the computer. This helps the radiologist to view the two different images easily and manipulate both separately to reveal different details.

As well as accurately locating the cancer in anatomical structures, the CT also helps to identify what abnormal areas are. The patient only has to be scanned once as two types of image are being acquired in one procedure.

The new equipment incorporates advanced systems that allow best quality images to be acquired and links the two types of image together automatically with a very high degree of precision.

Christie patients are already benefiting from this significant improvement in image quality, as well as monitoring of the progress of any therapy provided.

Staff involved in the gamma camera project 

As well as providing diagnostic information, the gamma camera is used to show exactly which areas of the body are being treated when therapeutic radiopharmaceuticals are administered (a procedure called molecular radiotherapy).

This is a type of therapy where the radiopharmaceutical seeks out the disease areas in the body and delivers therapy in precisely the right place to kill the cancer. New medicines of this type have recently become available, and many more patients are now being given this new type of therapy. The Christie has a particularly large molecular radiotherapy capability and facilities are constantly being expanded and improved.

Tumours accumulate these medicines and retain them for varying times, with different radiation doses being delivered to different tumour areas.

By taking a number of images using the new gamma camera over a period of time, the level of the therapy in different areas of the body can be mapped to ensure the patient is getting the best treatment and that the dose given is not having adverse effects on healthy tissue.

The calculations involved in converting the gamma camera images to therapy maps are very complex and the new SPECT / CT system includes an internal radiation dosimetry computer to make these automatically.

The Christie is working very closely with The University of Manchester to improve the accuracy of these calculations using this equipment.

This work will eventually allow personal therapy plans to be produced for patients undergoing some types of molecular radiotherapy, which will mean that their tumours get the most effective therapy and that normal tissues are protected.

There is no doubt that this is a very exciting time to be working in nuclear medicine at The Christie and my work on the gamma camera has been hugely rewarding.

I am delighted that so many fundraisers have enthusiastically backed this project and was delighted to show them the tangible progress we have made. The gamma camera will make a huge difference to the diagnosis and therapy of many Christie patients in the future and will hopefully help thousands to successfully beat theircancer.

The Christie charity supports the work of The Christie NHS Foundation Trust through its fundraising activities, and delivers projects, equipment and improvements that are over and above what the NHS funds. The charity has over 30,000 supporters who helped raise   £13.3m last year.