The Medical Physics Unit, University Malaya Medical Centre, Continuous Biomedical Education (CBIE), Department of Biomedical Imaging, University of Malaya and the Medical Physics Subgroup of the Malaysian Institute of Physics jointly organised the above seminar at the Sekapur Sireh Hall at the Trauma & Emergency Building of the University Malaya Medical Centre, Kuala Lumpur. There were about 120 delegates, mostly from the medical physics and radiography community.

This was the third in a series of educational seminars related to radiation. The overseas faculty consisted of Dr William Evans and Dr David Sutton who was also present last year in the Radiation Protection: Concept & Application seminar. Dr Sutton is Head of Radiation Physics, NInewells Hospital and Medical School, Dundee, United Kingdom whilst Dr William David Evans is Head of Medical Physics, University Hospital of Wales, Cardiff, United Kingdom(UK).

This whole day affair began with an overview of Ionising Radiation Update by Prof Dr Ng Kwan Hoong (PhD), followed by the Measurement of Bone Mineral Density by Dr William David Evans (PhD) and a clinical focused lecture on the Role of Bone Mineral Density in Assessing Fracture Risk by Prof Dr Chan Siew Pheng (Consultant Endocrinologist, University Malaya Medical Centre). The late morning sessions were on Realistic Shielding Calculations for X-ray Rooms and Patient & Staff Radiation Doses One Hundred Years Ago by Dr David Sutton (PhD) and Nuclear Medicine In Sentinel Node Localisation by Dr William Evans.

After break for lunch, the seminar continued with Perfusion CT Imaging: Image Evaluation of Brain Lesions by Assoc Prof Dr Wan A. Kamil Wan Abdullah (PhD, Department of Radiology, Universiti Sains Malaysia) and was then followed by a Forum discussing “Ionising Radiation in Medicine – Quo Vadis?”, chaired by Dr P. Sathyamoorthy. Dr Sathyamoorthy began with a very eloquent presentation of the overview of the increasing use of ionising radiation in medicine, particularly through the development of multislice CT scanners. The challenges presented and the controversies over the radiation risks in CT scans, especially when it came to screening CT scans. Sitting on the panel were also Prof Dr Basri Johan Jeet Abdullah, Dr Evelyn Ho Lai Ming and Prof Dr Wan A. Kamil.

Ionising radiation has been used in imaging human bodies for over 110 years. Today with great advancement in technological, medical as well as computer/information technology, biomedical imaging is playing an even more important role in healthcare. With modalities that utilise ionising radiation, therefore, the total increase in the exposure of the general population to radiation has increased. In fact, with the advent of multislice Computed Tomography Scanner and hybrid modalities such as Positron Emission Tomography & Computed Tomography (PET-CT), the doses of radiation to patients has reached levels of concern, yet, the benefits versus risk analysis may not be all doom and gloom! There is still some contention over the theoretical risks to patients and for low dose radiation, the main issue is that of induction of cancer over the lifetime after exposure.

Interestingly, the risks to staff were also discussed. In the previous century, the staff received dangerous doses because of lack of realisation of the effect of x-rays (new and exciting discovery of Xrays were in 1895) plus the “rudimentary” equipment design. Today, over the years, the design of the equipment, media for imaging and the knowledge of radiation including radiation protection (for example, shielding of xray rooms), staff doses does not put them at higher risk for some of the normal day to day activities such as smoking.
Both the physics behind bone mineral density measurement, the techniques used as well as the clinical application especially with respect to fracture risk prediction and thereby prevention was expounded. Two other areas of clinical application of ionising radiation were discussed at the seminar. One was that of sentinel lymph node localisation in breast cancer surgery – where if the sentinel node (the lymph node that receives lymphatic drainage directly from the primary cancer in the breast) was proven to be negative for cancer, the patient could avoid undergoing axillary lymph node clearance which potentially, could increase morbidity and increase operative time and stay in the hospital. The other was that of perfusion CT imaging in the evaluation of brain lesions.

Overall, the participants benefitted from the wide scope of the lectures and were updated on the roles of ionising radiation procedures and their importance in healthcare. In addition, it provided an opportunity to network and meet old friends, teachers –students alike and improve the teamwork in the ionising radiation related “community”. It also enabled exchange of information and an insight into radiation issues, radiation protection and also regulatory requirements in the United Kingdom.