Magnetic Resonance Imaging

Magnetic Resonance (MR) Imaging is a highly complex non-invasive type of imaging. It uses strong magnetic fields and radiofrequency waves to create detailed images of a patient’s internal anatomy and physiology. Unlike many other types of imaging, there is no ionising radiation hazard for the patient. The strong magnetic fields and radiofrequency waves create unique, serious hazards for patients with certain medical implants and for certain medical equipment, which require careful management.

The MR physics service at Christie Medical Physics and Engineering (CMPE) comprises several clinical scientists who divide their time across multiple departments within The Christie. They also work across over 40 scanners in NHS trusts in the North West of England via our regional contracts.

Our teams regularly work on site in each MR department, which allows us to smoothly integrate the important role of MR physics into a wide range of clinical services across the region. Our regular time spent on site at each Trust is crucial for us to provide such high level, integrated support.

The support we provide involves working closely with senior radiographers, radiologists, oncologists and radiology service managers to ensure the efficient and safe running of each service. The MR physics group members at The Christie pride ourselves on a friendly, inclusive and collaborative approach to delivering the very best service to MR departments and their patients.

The MR physics group supports a wide range of MR scanning activities at The Christie. The radiology department has one 3T and two 1.5T scanners and offers clinical imaging for patient diagnosis, routine follow up post cancer treatment, and radiotherapy treatment planning.

The proton beam therapy centre at The Christie has a 1.5T MR scanner to assist proton beam therapy treatment planning. The unique Elekta Unity MR-linac, which combines a linear accelerator and MR scanner, enables a patient to have 1.5T MR imaging and adaptive radiotherapy treatment on the same machine, in the same appointment.

In addition to our comprehensive routine clinical scientist support, the MR physics group provides additional support for the MR for radiotherapy (MR-RT) services at the trust via extensive system QA and service review. There is ongoing work to ensure MR imaging for external beam radiotherapy treatment planning meets the recommendations in the IPEM topical report. We provide high-level support in response to ad hoc requests for MR-RT sequence and QA support for new services both within the trust and externally across the region.

The MR physics group is actively involved in novel MR research, primarily through strong links to the Radiotherapy Related Research group at The University of Manchester. This research focuses on the development of MR techniques for guiding the delivery of radiotherapy and evaluating therapy response, and includes the use of oxygen-enhanced (OE) MRI, dynamic contrast-enhanced (DCE) MRI and diffusion MRI, on standard MR scanners and the MR-linac. This research forms part of the Radiotherapy BioAdaption theme within the Cancer Research UK Manchester Centre.

The MR physics group provides support to many NHS trusts throughout the North West of England. We tailor our service to the individual needs of each department. This unique position allows us to share best practice throughout the region and provide high level support to individual NHS trusts during the development of new local services.

Key elements of our service include:

  • Ensuring MR department compliance with the Control of Electromagnetic Fields at Work (CEMFAW) Regulations 2016
  • Provision and regular update of all necessary MR Safety Framework documentation and implant policies
  • MRSE services from our team of expert MR clinical scientists (including IPEM certified, and MRSCTM certified MRSEs)
  • Support with documentation to obtain and retain Quality Standard in Imaging (QSI) accreditation
  • Introduction of new services such as active medical device scanning, MR scanning of patients under general anaesthetic and the scanning of patients with off-label medical devices
  • Expert input to ensure that imaging protocols are optimised for both acquisition time and image quality
  • Specialist support with site planning and scanner specification when replacing, upgrading or installing additional MR equipment
  • Acceptance testing of any new equipment
  • Investigation of MR safety incidents
  • Ensuring the QA requirements of the NHSBSP Report 68 guidance are met for sites offering MR screening scans for women at higher risk of breast cancer

This is achieved through regular on-site, in-person visits to each department across the region. We also provide remote support via email, and video or phone calls for urgent queries. We regularly review our practice to develop and improve the service we offer to MR departments, and their patients, through audit and continuing professional development (CPD).  

The MR physics group has a major role in the NHS England Improvement (NHSEI) MRI advanced acceleration technology (AAT) project in the North West. We are supporting many trusts to implement this technology to achieve significant gains in imaging capacity in MR.  Our large MR physics group is ideally placed to lead and support projects such as this across the North West Imaging Networks.

The MR group has a strong tradition of delivering excellent MR safety and MR physics teaching. CMPE are the leading accredited training centre in the region for the training of new clinical scientists via the NHS Scientist Training Program (STP) and contribute to the development of clinical scientists via the Higher Specialist Scientific Training (HSST) program. We have a lead role in delivering training to provide the MR physics workforce required across the North West Imaging Networks.

In addition to STP and HSST, our teaching, training and outreach activities include:

  • Postgraduate teaching at the Universities of Manchester, Liverpool and Cumbria for MR radiographers and healthcare scientists
  • Teaching on the FRCR programme for radiologists
  • Regular, tailored MR safety and MR physics talks for MR radiographer colleagues across the region and nationally, in addition to the customer learning hub below
  • Online customer learning hub where we host a wide variety of training material for radiology staff across the region
  • Quarterly customer newsletter containing important MR safety and MR physics updates and educational material
  • Developing radiographer and physicist training programmes using MR simulation software as part of a Health Education England funded pilot study
  • Outreach and public engagement to highlight the work of medical physicists in healthcare

Across the MR group, we are involved with professional bodies and national activities including:

  • Membership of the IPEM MR SIG (Special Interest Group)
  • Scientific meeting organiser (e.g. IPEM MR in Radiotherapy meeting, Manchester, May 2022)
  • External advisor for IPEM route 2 training scheme
  • Association of Clinical Scientists (ACS) assessor for route 2 training scheme
  • National working parties and task and finish groups (e.g. membership of IPEM MR workforce task and finish group, membership of IPEM MR for RT working party)
  • Lead/chair for the North West Imaging Medical Physics Advisory Group
  • North West Imaging Academy Governance Board membership
  • Collaborating with North West regional diagnostic team at NHS England Improvement
  • Contributing articles to trade magazines such as SCOPE and Radmag

These voluntary roles bring huge benefits for both group members and the customers we support and ensure the MR group are closely involved in developing the profession and informing national policy making.

Mike Hutton – MR group lead, consultant clinical scientist

michael.hutton4@nhs.net

Mike is the MR group lead and a consultant clinical scientist specialising in MR. He has a MPhys (Hons) degree in Astrophysics from the University of Edinburgh and an MSc in Medical Physics from the University of Leeds. He took over the group lead role in 2019 having joined The Christie MR Physics Group in 2013. Before this, he was an MR clinical scientist in Sheffield having completed his medical physics training there. 

Mike has worked with many of the MR departments in the North West region during his time at The Christie.  His focus is now on leading the MR physics group through challenging times and developing MR physics support services within the North West Imaging Networks.

Mike is secretary of the Institute of Physics and Engineering in Medicine (IPEM) MR Special Interests Group and is increasingly involved in UK-wide initiatives and working parties in the field of MR. Mike is an American Board of Magnetic Resonance Safety (ABMRS) certified MR Safety Expert (MRSCTM).

Dr Jude Kilgallon – principal clinical scientist

judith.kilgallon@nhs.net 

Jude joined The Christie as a trainee clinical scientist having completed her degree in Physics from the University of Leeds and PhD in Experimental Nuclear Structure Physics from The University of Manchester. Jude leads the support of our trainee clinical scientists and is heavily involved with the group’s teaching activities. Her clinical work stretches across much of the group’s regional service.

Steve Jackson – principal clinical scientist

steven.jackson6@nhs.net 

Steve completed the NHS Scientist Training Programme (STP) with the MR group in 2018, following a BSc (Hons) in maths and physics and an MSc in theoretical physics. His current work involves leading the MR imaging support for radiotherapy treatment planning services at The Christie, and clinical scientist support for several MR departments in Greater Manchester and the North West of England. Steve has a strong track record teaching MR physics and MR safety, including significant input into the design of the ‘Clinical MRI’ CPD module at the University of Liverpool. In April 2022, he became an IPEM certified MR Safety Expert (MRSCTM).

Michael Dubec – principal clinical scientist

michael.dubec@nhs.net 

Michael joined the MR group in 2014 after completing a BSc (Hons) in Physics, an MSc in Medical Radiation Physics and an MSc in Clinical Science (Medical Physics) as part of the NHS Scientist Training Programme. In addition to his clinical duties, Michael is heavily involved with developing MR for radiotherapy planning, guidance and assessing treatment response and was co-author of the IPEM national guidance on MR for radiotherapy treatment planning. He is also currently undertaking a part-time PhD entitled ‘Optimising oxygen-enhanced MRI biomarkers of hypoxia for use in advanced radiotherapy’.

Dr David Buckley – honorary MR physicist

david.buckley5@nhs.net 

David joined the group in July 2020. He is seconded to the group part-time from his job at the University of Leeds as a Professor of Medical Physics specialising in MRI. David’s role at The Christie is to support MRI in the radiology department (both clinical practice and research) and to support studies on the MR simulator in the proton beam therapy centre and the MR-linac.

David has a wealth of experience in MRI research, having obtained his PhD in MRI back in the previous century. Between 1999 and 2008, he worked for The University of Manchester where he was involved in several studies at The Christie and acted as a PhD supervisor.

Chris Moore – clinical scientist

christopher.moore24@nhs.net 

Chris completed an undergraduate physics degree at The University of Manchester. After a brief time as a software engineer, he successfully applied for the Scientist Training Programme (STP) in medical physics. He completed the programme in September 2021 and has taken on a clinical role in the MR group.

Chris splits his time between supporting MR for radiotherapy work at The Christie and clinical scientist support at multiple sites in the region, as well as contributing to the department’s teaching and research work. Chris leads the group’s quality assurance (QA) service as part of the NHS Breast Screening Programme MRI screening for women at higher risk of developing breast cancer.

Dr Damien McHugh – MR physicist

damien.mchugh@nhs.net 

Damien joined the MR group in January 2021. He is currently working towards acquiring his HCPC registration, having completed a PhD at The University of Manchester. His research was mainly focused on diffusion-weighted imaging and his PhD thesis was entitled ’The effect of tumour microstructure on diffusion-weighted MRI measurements'.

Damien has a 50/50 split role within the group, dedicating half of his time to providing clinical MR support to our regional sites and utilising his strong academic background for the other half by supporting radiotherapy-related MR research at The Christie. 

Guy Drabble – clinical scientist

g.drabble@nhs.net 

Guy originally joined The Christie back in 2014 on the medical physics STP, having completed a degree in physics with particle physics and cosmology. He completed his training in 2017, specialising in radiotherapy and gaining his MSc in Clinical Science (Medical Physics).

Guy briefly left The Christie in 2019 to work in the education sector. Working at The University of Manchester, he helped to run the academic section of the Higher Specialist Scientist Training (HSST) programme. Guy returned to The Christie in June 2021 to join the MR group and retrain as an MR physicist.

Asher Ezekiel – trainee clinical scientist

asher.ezekiel@nhs.net 

Asher joined the MR group through the medical physics STP and is in the specialist part of his training. Before this, Asher completed his undergraduate degree in Physics at the University of Birmingham. He then moved to London to join a publishing company, working for a science journal covering research across biology, chemistry and physics. During this time, he also completed an MSc in Astrophysics at Queen Mary, University of London.

Asher moved up to Manchester to start his STP training in September 2020, specialising in MRI.

The MR group is active in the MR research community. Across the group, we regularly author and contribute to scientific papers and present at national and international research meetings. 

Recent publications

2022

  • Andreas Wetscherek, Erik van der Bijl, Astrid L. H. van Lier, Joan Chick, Steven Jackson, Stephen Gibson, Vivian van Pelt, Signe W. Hasler and Rob H. N. Tijssen, Longitudinal Stability of MRI QA up to Two Years on Eight Clinical 1.5 T MR-Linacs. Front. Phys., 13 June 2022 Sec.Medical Physics and Imaging https://doi.org/10.3389/fphy.2022.891600
  • Rosie B Hales, Robert Chuter, Alan McWilliam, Amal Salah, Michael Dubec, Linnea Freear, Lisa McDaid, Marianne Aznar, Marcel van Herk, Andrew McPartlin, Cynthia L Eccles. The impact of gadolinium-based MR contrast on radiotherapy planning for oropharyngeal treatment on the MR Linac. Medical Physics, 2022 Jan;49(1):510-520. doi: https://doi.org/10.1002/mp.15325.  

2021

  • Lewis D, McHugh DJ, Li K-L, Zhu X, McBain C, Lloyd SK, Jackson A, Pathmanaban ON, King AT, Coope DJ. Detection of early changes in the post-radiosurgery vestibular schwannoma microenvironment using multinuclear MRI. Scientific Reports 2021;1115712. https://doi.org/10.1038/s41598-021-95022-6
  • McDaid L, Hutton M, Cooper L, Hales RB, Parry C, Waters J, Rodgers JE, Doherty W, Eccles CL. Developing electronic learning to deliver MR safety training in a radiotherapy department. J Med Imaging Radiat Sci. 2021 Dec;52(4S):S24-S31. https://doi.org/10.1016/j.jmir.2021.05.012
  • McHugh DJ, Porta N, Little RA, Cheung S, Watson Y, Parker GJM, Jayson GC, O'Connor JPB. Image contrast, image pre-processing, and T1 mapping affect MRI radiomic feature repeatability in patients with colorectal cancer liver metastases. Cancers 2021;13:240. https://doi.org/10.3390/cancers13020240
  • Speight, R, Dubec, M, Eccles, CL, George, B, Henry, A, Herbert, T, Johnstone, RI, Liney, GP, McCallum, H & Schmidt, MA. 'IPEM topical report: Guidance on the use of MRI for external beam radiotherapy treatment planning', Physics in Medicine and Biology, 2021, vol. 66, no. 5, 055025. https://doi.org/10.1088/1361-6560/abdc30 
  • Speight, R, Tyyger, M, Schmidt, MA, Liney, GP, Johnstone, R, Eccles, CL, Dubec, M, George, B, Henry, A, Herbert, T, Nyholm, T, Mahmood, F, Korhonen, J, Sims, R, Tijssen, RHN, Vanhoutte, F, Busoni, S, Lacornerie, T & McCallum, HM. 'IPEM Topical Report: an international IPEM survey of MRI use for external beam radiotherapy treatment planning', Physics in Medicine and Biology, 2021. vol. 66, no. 7, 075007. https://doi.org/10.1088/1361-6560/abe9f7  
  • Dubec M, Brown S, Chuter R, Hales R, Whiteside L, Rodgers J et al. MRI and CBCT for lymph node identification and registration in patients with NSCLC undergoing radical radiotherapy. Radiotherapy and oncology: journal of the European Society for Therapeutic Radiology and Oncology. 2021 Jun 1;159:112-118. https://doi.org/10.1016/j.radonc.2021.03.015 

2020

  • Meshal Alzahrani, David A Broadbent, Robert Chuter, Bashar Al-Qaisieh, Steven Jackson, Hutton Michael, Robert I Johnstone, Simon Shah, Andreas Wetscherek, H. Joan Chick, Jonathan J Wyatt, Hazel Mhairi McCallum, Richard Speight. Audit feasibility for geometric distortion in magnetic resonance imaging for radiotherapy, Physics and Imaging in Radiation Oncology, Volume 15, 2020, Pages 80-84, https://doi.org/10.1016/j.phro.2020.07.004
  • Bellhouse S, Brown SM, Dubec M, Taylor S, Hales R, Whiteside L et al. Introducing magnetic resonance imaging into the lung cancer radiotherapy workflow – An assessment of patient experience. Radiography. 2020 May 23. https://doi.org/10.1016/j.radi.2020.04.020
  • Shortall, J, Vasquez Osorio, E, Mackay, R, Song, YP, Kirkby, K, Cree, A, Dubec, M, Chuter, R, Mcwilliam, A, Price, G & Van Herk, M. 'Inter- and intra-fractional stability of rectal gas in pelvic cancer patients during MRIgRT', Medical Physics, 2020. https://doi.org/10.1002/mp.14586  

2019

  • Jackson S, Glitzner M, Tijssen RHN, Raaymakers BW. MRI B 0 homogeneity and geometric distortion with continuous linac gantry rotation on an Elekta Unity MR-linac. Phys Med Biol. 2019 Jun 10;64(12):12NT01. https://doi.org/10.1088/1361-6560/ab231a
  • Tijssen RHN, Philippens MEP, Paulson ES, Glitzner M, Chugh B, Wetscherek A, Dubec M et al. MRI commissioning of 1.5T MR-linac systems – a multi-institutional study. Radiotherapy and Oncology. 2019 Mar 1;132:114-120. Available from, DOI: https://doi.org/10.1016/j.radonc.2018.12.011
  • Richard Speight, Maria A Schmidt, Gary P Liney, Robert I Johnstone, Cynthia L Eccles, Michael Dubec, Ben George, Ann Henry and Hazel McCallum. IPEM Topical Report: A 2018 IPEM survey of MRI use for external beam radiotherapy treatment planning in the UK. Phys. Med. Biol. 64 (2019) 175021. DOI: https://doi.org/10.1088/1361-6560/ab2c7c 

2018

  • van Herk M, McWilliam A, Dubec M, Faivre-Finn C, Choudhury A. Magnetic Resonance Imaging–Guided Radiation Therapy: A Short Strengths, Weaknesses, Opportunities, and Threats Analysis. International Journal of Radiation Oncology Biology Physics. 2018 Aug 1;101(5):1057-1060. Available from, DOI: https://doi.org/10.1016/j.ijrobp.2017.11.009
  • Cree A, Livsey J, Barraclough L, Dubec M, Hambrock T, Van Herk M et al. The Potential Value of MRI in External-Beam Radiotherapy for Cervical Cancer. Clinical Oncology. 2018 Nov 1;30(11):737-750. Available from, DOI: https://doi.org/10.1016/j.clon.2018.08.002
  • Datta A, Aznar MC, Dubec M, Parker GJM, O'Connor JPB. Delivering Functional Imaging on the MRI-Linac: Current Challenges and Potential Solutions. Clinical Oncology. 2018;30(11):702-710. Available from, DOI: https://doi.org/10.1016/j.clon.2018.08.005

Selected conference involvement (asterisk denotes speaker for oral presentations)

2022

  • M Dubec*, A Datta, A Clough, DL Buckley, RA Little, M Berks, S Cheung, C Eccles, D Higgins, JH Naish, JC Matthews, M van Herk, RG Bristow, GJ Parker, P Hoskin, A McPartlin, A Choudhury, JP O’Connor, ESTRO (Copenhagen). Presentation: First-in-human clinical translation of oxygen-enhanced MRI onto an MR Linac.
  • M Dubec*, A Datta, RA Little, A Clough, DL Buckley, C Hague, M Berks, S Cheung, A Salah, D Higgins, C Eccles, RG Bristow, JH Naish, JC Matthews, P Hoskin, M van Herk, , GJ Parker, A Choudhury, A McPartlin, JPB O’Connor, ISMRM (London). Presentation: First in-human technique translation of OE-MRI for hypoxia imaging onto an MR Linac system in patients with head and neck cancer.
  • M Dubec*, A Datta, RA Little, A Clough, DL Buckley, C Hague, M Berks, S Cheung, A Salah, D Higgins, C Eccles, RG Bristow, JH Naish, JC Matthews, P Hoskin, M van Herk, , GJ Parker, A Choudhury, A McPartlin, JPB O’Connor, Elekta MR Linac Consortium Meeting (Texas & virtual). Presentation: First in-human technique translation of OE-MRI for hypoxia imaging onto an MR Linac system in patients with head and neck cancer.
  • S Jackson, UKIO (Liverpool). Invited Speaker: Implementing advanced acceleration technology (AAT) in clinical MR (BAMRR session).
  • S Jackson*, D McHugh, C Moore, G Drabble, D Buckley, IPEM MR in RT meeting (Manchester). Presentation: Evaluating an existing MR for RT service against IPEM guidance.
  • D McHugh, UKIO (Liverpool). Invited speaker: MR functional imaging techniques - basic principles.
  • A Clough*, D McHugh*, M Dubec, L Barraclough, K Haslett, A Choudhury, C Eccles, Elekta MR-Linac Consortium meeting (Texas & virtual). E-poster: DW-MRI in the cervix: repeatability and on-treatment changes of the apparent diffusion coefficient.
  • D McHugh*, M Dubec, J Price, C Moore, D Buckley, JPB O'Connor, A McPartlin, ISMRM (London). E-poster: Identifying perfused tissue regions through IVIM and ADC model comparison: technical validation.
  • C Moore, D McHugh*, A Clough, J Stickley, R Chuter, A Choudhury, M Dubec ISMRM (London). Lightning presentation: Daily Measurement of Prostate ADC in Patients Undergoing SABR and Conventional Treatment for Prostate Cancer on an MR-Linac
  • C Moore, D McHugh, A Clough, J Stickley, R Chuter, A Choudhury, M Dubec, ESTRO (Copenhagen) E-poster: Daily Measurement of Prostate ADC in Patients Undergoing SABR and Conventional Treatment for Prostate Cancer on an MR-Linac.
  • C Moore*, D McHugh, A Clough, J Stickley, R Chuter, A Choudhury, M Dubec IPEM MR in RT (Manchester). Oral presentation: Daily prostate ADC in patients having SABR or conventional prostate radiotherapy on an MR-Linac

2021

  • M Dubec, Christie Radiotherapy Summer School (Manchester). Invited talk: Optimising MRI for Radiotherapy.
  • M Hutton, BAMRR Annual meeting 2021 (online). Invited speaker: Hydrocephalus shunts and MR.
  • S Jackson, IPEM MR Safety Update (online). Invited Speaker: Imaging Cochlear Implants Safely.
  • S Jackson*, C Moore, A Wetscherek, IPEM MR QA conference (online). Lightning Presentation: Annual Review of B0 Homogeneity QA on the Elekta Unity MR Linac.
  • C Moore*, S Jackson, M Dubec, IPEM MR QA conference (online). Monthly Quantitative Diffusion QA Using the HPD Diffusion Phantom on a MR-Linac.

2020

  • S Jackson, H Hanson, D Cobben, K Banfill, A Salem, L McDaid, M van Herk, B Rowland, ISMRM (online). E-poster: Intrinsically Registered Fat Saturated and Unsaturated T2W Images Using a Keyhole Method

2019

  • S Jackson*, A Cree, R Chuter, A McWilliam, IPEM MR in RT meeting (Edinburgh). Presentation: Simulation of Automatic Contour Propagation using Previous Imaging on an MR-linac.
  • S Jackson*, M Glitzner, RHN Tijssen, BW Raaymakers, ESTRO (Milan) Presentation: Feasibility of MRI-guided VMAT: investigating image quality during gantry rotation on an MR-linac.
  • M Hutton, UKIO (Liverpool). Invited speaker: MR Linac.
  • M Dubec*, A Salem, Y Watson, R Little, C Faivre-Finn, J Matthews, M van Herk, JPB O’Connor, GJM Parker, ISMRM (Montreal). Presentation: Dynamic OE-MRI mapping of lung parenchymal radiotherapy effects in non-small cell lung cancer patients.

2018

  • M Hutton, BAMRR Annual meeting (Birmingham). Invited speaker: Cochlear implant safety in MRI.
  • M Dubec*, A Salem, Y Watson, R Little, C Faivre-Finn, J Matthews, M van Herk, JPB O’Connor, GJM Parker, Elekta MR-Linac Consortium Meeting (Manchester). Oral Presentation: MR-Linac for Lung Cancer.
  • M Dubec, Christie Radiotherapy Summer School (Manchester). Invited Talk: The role of MR in radiotherapy.