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AHM 244 Introduction to Imaging. Principles of Radiology X-rays (discovered late 19 th century) X-rays (discovered late 19 th century) Computed Tomography.

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Presentation on theme: "AHM 244 Introduction to Imaging. Principles of Radiology X-rays (discovered late 19 th century) X-rays (discovered late 19 th century) Computed Tomography."— Presentation transcript:

1 AHM 244 Introduction to Imaging

2 Principles of Radiology X-rays (discovered late 19 th century) X-rays (discovered late 19 th century) Computed Tomography (CT scan) Computed Tomography (CT scan) Sonography (ultrasound) Sonography (ultrasound) Fluoroscopy Fluoroscopy Nuclear Medicine – used for diagnostic and therapeutic procedures Nuclear Medicine – used for diagnostic and therapeutic procedures Magnetic Resonance Imaging (MRI) Magnetic Resonance Imaging (MRI) Positron Emission Tomography (PET) Positron Emission Tomography (PET)

3 X-rays Radiography High energy waves that cannot be seen or felt High energy waves that cannot be seen or felt Similar to photographs Similar to photographs Radiopaque – do not permit passage of x-rays i.e. bones; show up on x-ray Radiopaque – do not permit passage of x-rays i.e. bones; show up on x-ray Radiolucent – permit the passage of x-rays i.e. soft tissue; do not show up on x-ray Radiolucent – permit the passage of x-rays i.e. soft tissue; do not show up on x-ray

4 X-rays Patient Positioning 2-dimensional 2-dimensional Requires 2 exposures 90 degrees to each other Requires 2 exposures 90 degrees to each other May require multiple positions and views May require multiple positions and views Review standard positions in handouts and in text Review standard positions in handouts and in text Review exam sequencing in text Review exam sequencing in text positions.htm positions.htm positions.htm positions.htm Radiation Safety Can cause cellular or genetic damage Minimize exposure Avoid unnecessary exams Limit area of body exposed Shield sensitive body parts Pregnancy status Workers: Use shielding Wear dosimeter

5 Diagnostic Procedures Mammography – Mammography – x-ray examination of the breast Vital adjunct to biopsy Vital adjunct to biopsy Performed yearly after age 40 or sooner with history or suspicion Performed yearly after age 40 or sooner with history or suspicion

6 Diagnostics cont… Contrast Studies Used to differentiate structures Used to differentiate structures Introduced via IV, catheter, orally Introduced via IV, catheter, orally Iodine – blood vessels; if allergic to shellfish, do not use iodine! Iodine – blood vessels; if allergic to shellfish, do not use iodine! Barium – intestines and stomach Barium – intestines and stomach Air - Joints Air - Joints

7 Fluoroscopy Use of x-rays to observe movement within body Use of x-rays to observe movement within body Contrast mediums used such as barium or iodine Contrast mediums used such as barium or iodine Blood flow, beating heart, digestive tract Blood flow, beating heart, digestive tract Also used to aid in reducing fractures or implanting devices such as pacemakers, stents, etc.. Also used to aid in reducing fractures or implanting devices such as pacemakers, stents, etc..

8 Computed Tomography Cross-sectional group of x- rays that target a specific site Cross-sectional group of x- rays that target a specific site Tube circles the patient, computer analyzes to create the cross-sectional views Tube circles the patient, computer analyzes to create the cross-sectional views Done with and without contrast Done with and without contrast Organs can be viewed from all angles Organs can be viewed from all angles

9 CT Cont….

10 Sonography Ultrasound Non-invasive Non-invasive Uses high-frequency sound waves Uses high-frequency sound waves Creates cross-sectional still views or views in real time movement with help of a computer Creates cross-sectional still views or views in real time movement with help of a computer Used for heart function, abdominal and pelvic structure views and fetal visualization Used for heart function, abdominal and pelvic structure views and fetal visualization

11 Sonography cont…

12 MRI Magnetic Resonance Imaging Uses high-intensity magnetic fields (magnets), radio waves and computer analysis to create cross-sectional images Uses high-intensity magnetic fields (magnets), radio waves and computer analysis to create cross-sectional images Used for central nervous system studies, joint structure, etc. Used for central nervous system studies, joint structure, etc. Done with or without contrast Done with or without contrast Claustrophobia is an issue Claustrophobia is an issue Metal implants from surgeries is a contraindication Metal implants from surgeries is a contraindication Patient must remove any jewelry and other metal objects Patient must remove any jewelry and other metal objects

13 MRI cont…

14 Nuclear Medicine Small amounts of radionuclides (radioactive materials) are injected Small amounts of radionuclides (radioactive materials) are injected These concentrate in specific areas of body These concentrate in specific areas of body Computer cameras detect particles and create an image Computer cameras detect particles and create an image Used to study thyroid, brain, lungs, liver, spleen, kidney, bone and breast Used to study thyroid, brain, lungs, liver, spleen, kidney, bone and breast Positron Emission Tomography (PET) Positron Emission Tomography (PET) Single Photon Emission Computed Tomography (SPECT) Single Photon Emission Computed Tomography (SPECT) Assists with diagnosis of cellular abnormalities esp. cancer Assists with diagnosis of cellular abnormalities esp. cancer

15 Nuclear Medicine cont…

16 Interventional Radiologic Procedures Designed to treat specific disease conditions – helps patients avoid surgeries, life- saving Percutaneous Transluminal Coronary Angioplasty (PTCA) – balloon angioplasty; used to enlarge lumen of blocked artery Percutaneous Transluminal Coronary Angioplasty (PTCA) – balloon angioplasty; used to enlarge lumen of blocked artery Laser Angioplasties – use lasers to remove deposits in vessels Laser Angioplasties – use lasers to remove deposits in vessels Vascular Stents – plastic or wire tubes inserted into a constricted vessel to open it; this procedure is guided by fluoroscopy Vascular Stents – plastic or wire tubes inserted into a constricted vessel to open it; this procedure is guided by fluoroscopy Embolizations – artificially stop bleeding from a blood vessel or reduce blood flow to a diseased area of an organ Embolizations – artificially stop bleeding from a blood vessel or reduce blood flow to a diseased area of an organ

17 PTCA

18 Laser Angioplasty

19 Vascular Stent

20 Embolization

21 Radiation Therapy Major force in fight against cancer Major force in fight against cancer Uses high-energy radiation to kill cancer cells Uses high-energy radiation to kill cancer cells Used in conjunction with surgery and chemotherapy (drug therapy) Used in conjunction with surgery and chemotherapy (drug therapy) Precise and carefully planned by radiation oncologist (MD specializing in radiology) Precise and carefully planned by radiation oncologist (MD specializing in radiology) Each treatment must be identical to a specifically defined area of the body Each treatment must be identical to a specifically defined area of the body Side effects: weight loss, hair loss, loss of appetite, skin changes, digestive system disturbances Side effects: weight loss, hair loss, loss of appetite, skin changes, digestive system disturbances

22 Patient Education & Preparation Help alleviate anxiety Help alleviate anxiety Calm fears Calm fears Explain procedures Explain procedures Explain preparation – different for each test from no prep to liquid diet and laxatives Explain preparation – different for each test from no prep to liquid diet and laxatives Assist as needed Assist as needed Post procedure education Post procedure education

23 Handling and Storage of Radiographic Films Protect unexposed films from extremes of temperature and light Protect unexposed films from extremes of temperature and light Exposed films kept in protective sleeves Exposed films kept in protective sleeves Maintain patient confidentiality per HIPAA Maintain patient confidentiality per HIPAA Correct labeling of patient films Correct labeling of patient films Films obtained on site remain part of patient record – films belong to the site that performed the procedure; can be signed out by patient or sent by courier to specialist or PCP Films obtained on site remain part of patient record – films belong to the site that performed the procedure; can be signed out by patient or sent by courier to specialist or PCP Digital films can be kept in the EMR Digital films can be kept in the EMR Written summary sent to providers of patient care Written summary sent to providers of patient care Teleradiology – computed imaging and information systems; many places use (PACS) Picture Archiving and Communication System to store films on computers Can outsource films this way to other countries even for a radiologist to read films; consults with specialists from around the world is possible with this system and in rural areas Can outsource films this way to other countries even for a radiologist to read films; consults with specialists from around the world is possible with this system and in rural areas


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