Ateneo - UPO

This integrated course provides the anatomical-clinical foundations and technical-methodological skills essential for performing diagnostic imaging examinations using ionizing radiation. By integrating topographic anatomy, skeletal and thoracic radiology, and contrast-enhanced procedures, students will acquire the ability to perform radiological examinations while optimizing patient positioning and ensuring adherence to radiation protection and safety principles

Recommended Reference Texts
Fernando Mazzucato, *Anatomia Radiologica e Tecnica Operativa Radiologica*, Piccin-Nuova Libraria (latest edition).

R. Passariello, G. Simonetti, *Elementi di Tecnologia Radiologica e Diagnostica per Immagini*, Idelson-Gnocchi.

Texts for Consultation and Further Study
A.S. Whitley, C. Sloane, et al., *Clark's Positioning in Radiography*, CRC Press (English edition or Italian translation).

C. Merrill, *Atlas of Radiographic Positioning and Procedures*, Mosby Elsevier.

General Objectives (Dublin Descriptors)
• Knowledge and understanding: Recognize anatomical structures visible in radiographic images and understand the physical-technical principles underlying image formation, both with and without contrast media.
• Applying knowledge and understanding: Correctly set technical parameters (kV, mAs, focal spot, filters) and safely perform standard and special radiographic positioning.
• Making judgments: Critically evaluate the technical quality of the radiograph (contrast, resolution, absence of artifacts) and verify the correct administration of contrast media.
• Communication skills: Interact empathetically with the patient before and during the examination to ensure cooperation, while maintaining professional communication with the radiologist and the medical team.
Course-Specific Objectives
1. Conventional Clinical Radiological Anatomy: Correlate the topographic and radiological anatomy of the human body with projectional radiological anatomy.
2. Conventional Radiology Techniques: Master standard and special radiographic projections for skeletal segments, the thorax, and the abdomen.
3. Contrast Radiology Techniques: Understand the indications, management, procedures, and positioning for contrast-enhanced examinations (digestive, urinary, and vascular systems).

Fundamental knowledge of general human anatomy and medical physics (with particular reference to radiation-matter interaction and X-ray production).
Basic knowledge of radiation protection and workplace safety.

• Lectures and interactive sessions: Supported by slides and guided discussions of actual images and radiographs.
• Practical exercises and simulation workshops: Hands-on practice using phantoms/mannequins to learn positioning, centering, and detector usage.
• PBL (Problem-Based Learning) and case studies: Analysis of real clinical cases, including image quality assessment and the identification of technical or positioning errors.

Attendance Requirements: Attendance at lectures and practical exercises/laboratory sessions is mandatory for at least 75% of the total hours prescribed by the Degree Programme regulations.
Office Hours: Instructors for individual modules are available to meet with students by appointment, which must be arranged via email at least 48 hours in advance.
Support for Students with Disabilities or Specific Learning Disorders (SLD): In accordance with University regulations, educational aids, extra time, and/or equivalent or personalized exam arrangements are available upon contact with the Inclusion Office and the course instructors.

The Integrated Course examination consists of a single test comprising two phases:
1. Written / Image-based Practical Test:
- Multiple-choice test and/or short open-ended questions to assess theoretical knowledge of anatomy and contrast-enhanced radiology.
- Anatomical and radiographic image analysis: Identification of anatomical structures, radiographic projections, and any centering or exposure errors on displayed radiographs.
2. Final Oral Examination:
- Discussion of syllabus topics, verbal simulation of patient positioning, and explanation of contrast media management procedures.

Module 1: Clinical Radiologic Anatomy (Conventional Radiography)
• Projectional anatomy of the musculoskeletal system: Skull, vertebral column, thoracic cage, pelvis, and limbs (upper and lower).
• Radiologic anatomy of the thorax and abdomen: Mediastinal structures, lung parenchyma, cardiac contours, visceral shadows, and identification of bony landmarks.
• Anatomical signs on radiographs: Recognition of radiopaque and radiolucent structures, anatomical superimpositions, and their interpretation in 3D/2D space.
Module 2: Conventional Radiography Techniques
• Exposure parameters and image quality: Voltage (kV), current and time (mAs), source-to-image distance, anti-scatter grids, detection systems (DR/CR).
• Radiographic projection techniques:
o Appendicular and axial skeleton (standard and supplementary projections).
o Thorax (PA, lateral, decubitus views) and Abdomen (erect and supine positions).
• Operational radiation protection: Centering criteria, beam collimation, gonadal shielding, and dose delivery according to the ALARA principle.
• Management of trauma or uncooperative patients: Adapting standard projections to clinical conditions.
Module 3: Contrast Radiography Techniques
• Classification of Contrast Media (CM): Barium-based and water-soluble iodinated CM, positive and negative agents; physicochemical properties and routes of administration.
• Imaging techniques for the digestive system: Upper tract (swallowing function, esophagogram), upper gastrointestinal tract (proximal segment), barium enema, and double-contrast studies. • Imaging techniques for the urinary tract and other regions: Intravenous urography, cystourethrography, hysterosalpingography, sialography.
• Management of emergencies and adverse reactions: Contrast media risk profile, patient preparation, and the role of the radiographer (TSRM) in managing adverse reactions.

Upon completion of the integrated course, the student will be able to:
- Describe and correlate details of the topographic and projectional radiological anatomy of the human body (axial and appendicular skeleton, thoracic and abdominal regions).
- Classify contrast media (properties, routes of administration, indications, and contraindications) and illustrate their interaction mechanisms in radiographic examinations.
- Explain the radiographic image formation chain (CR/DR systems) and the function of exposure parameters (kV, mAs, source-to-film distance, anti-scatter grids).
- Independently plan and execute correct patient positioning for standard, supplementary, and special radiographic projections.
- Prepare equipment and assist in performing contrast-enhanced examinations (digestive tract, urinary tract, etc.), correctly applying operational and safety protocols.
- Apply radiation protection standards to minimize radiation dose (collimation, shielding, ALARA principle).
- Critically and independently evaluate the technical and image quality of the radiograph (contrast, resolution, centering accuracy, absence of artifacts) and determine whether the examination needs to be repeated.
- Use precise technical-scientific language when interacting with the radiologist and members of the multidisciplinary team.
- Adopt an empathetic, clear, and reassuring communication style with the patient to ensure maximum cooperation during the examination.
- Consult and critically understand relevant scientific literature, guidelines, and radiological technique manuals to ensure continuous professional development.