2. Chapter 26 Radiology Health Care Science Technology Copyright © The McGraw-Hill Companies, Inc.

3. Chapter 26 2 Objectives Summarize two primary roles of the radiologist. Define radiologic technologist and identify three primary roles. List the advanced practice roles of the radiologic technologist.

4. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 3 Objectives (cont.) Describe settings in which radiologists and radiologic technologists work. Differentiate between invasive and noninvasive diagnostic imaging procedures.

5. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 4 Objectives (cont.) Discuss the steps required to protect the client and radiologic health care personnel from unnecessary radiation exposure. Identify the importance of the Inverse Square Law. Successfully complete 1 radiologic procedure.

6. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 5 Careers in Radiology and Radiologic Technology 26-1 Radiologist Radiologic Technologist Radiology Aide

7. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 6 Radiologist Doctor who specializes in the use of radiant energy to diagnose and treat disease. Works in hospitals, the private sector, or diagnostic imaging or radiation therapy treatment centers. May specialize in diagnostic radiology or radiation oncology.

8. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 7 Radiologist (cont.) Diagnostic Radiologist Job Responsibilities – Conduct general and specialized imaging examinations of the entire human body. Noninvasive imaging – studies taken from outside the body that do not require the use of contrast media. Invasive imaging – studies taken from inside the body that require needles or catheters to be inserted into the body.

9. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 8 Radiologist (cont.) Diagnostic Radiologist Job Responsibilities (cont.) – Maintain aseptic and sterile techniques and use standard precautions. – Use various imaging modalities. – Administer contrast agents. – Respond to emergencies and administer drugs.

10. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 9 Radiologist (cont.) Diagnostic Radiologist Job Responsibilities (cont.) – Use the fluoroscope. – Conduct the diagnosis of findings from all images and generate a written report. – Supervise the diagnostic imaging team.

11. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 10 Radiologist (cont.) Examinations Performed by Diagnostic Radiologists – Noninvasive imaging is usually delegated to technologists. – Invasive imaging requires contrast media, substances that allow internal images to be viewed.

12. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 11 Radiologist (cont.) Coronary Angiography – An invasive procedure that determines where a coronary artery is narrowed or blocked. – Angiograms show both arteries and veins filled with a contrast media. – An arteriogram is an image of only arteries filled with a contrast media.

13. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 12 Radiologist (cont.) Fluoroscopy – An imaging process. – Used to advance a catheter through the artery into the heart, and then into the coronary artery. – Radiologists look for lines that are narrower than normal, indicating the presence of plaque. – A line that stops abruptly indicates a blood clot, or atheroma.

14. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 13 Radiologist (cont.) Radiation Oncologist Job Responsibilities – To determine a tumor treatment plan for a client. – To cure, relieve pain and distress, enhance the action of drugs, or to establish local tumor control.

15. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 14 Radiologist (cont.) Radiation Oncologist Job Responsibilities (cont.) – Maintain aseptic and sterile techniques and standard precautions. – Use radiation to deliver treatments. – Identify the volume of the client’s body to be treated.

16. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 15 Radiologist (cont.) Radiation Oncologist Job Responsibilities (cont.) – Explain the treatment plan to the client and obtain informed consent. – Use positioning and immobilizing devices. – Assess the client’s tumor response after radiation therapy treatments. – Supervise the radiation oncology team.

17. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 16 Radiologist (cont.) Radiation Therapy Performed by Radiation Oncologists – External beam therapy – usually delivered in daily doses for several weeks. – Brachytherapy – involves using radio-nuclide sources to treat tumors inside the body.

18. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 17 Radiologist (cont.) Linear Accelerator (LINAC) – Uses microwave technology to accelerate electrons and produce X rays.

19. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 18 Radiologic Technologist Uses radiant energy to produce diagnostic images or dispense treatments.

20. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 19 Radiologic Technologist (cont.) Supervised by a radiologist. Certified by the American Registry of Radiologic Technologists. Can become members of the American Society of Radiologic Technologists.

21. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 20 Radiologic Technologist (cont.) Education and Employment – Fields include: Radiography. Nuclear medicine technology. Radiation therapy technology. – Advanced practice certification areas are also available with additional education.

22. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 21 Radiologic Technologist (cont.) Continuing Education – Registered technologists must receive a minimum of 24 approved continuing education units within a 24-month period. – Otherwise, they must complete additional education and training to maintain good standing with the ARRT.

23. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 22 Radiologic Technologist (cont.) Employment Opportunities – Many work in hospital radiology departments. – Others may work in private physician offices, diagnostic-imaging centers, and emergency care clinics. – About two-thirds are employed as radiographers.

24. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 23 Radiologic Technologist (cont.) Radiographer Job Responsibilities – May perform fluoroscopy. – Use contrast media to make viewing X rays easier.

25. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 24 Radiologic Technologist (cont.) Fluoroscopy – Projects the X-ray image on a television screen. – Saves image on videotape, for viewing by a physician. – Can also be intercepted by X- ray film in a cassette holder, called a spot film.

26. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 25 Radiologic Technologist (cont.) Contrast Media – A radiopaque substance prevents passage of X rays to the film emulsion or digital imaging plate, which makes viewing easier.

27. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 26 Radiologic Technologist (cont.) Nuclear Medicine Technologist – Uses radioisotopes that tell how well the human anatomy functions. – Injects radioisotopes into the body. – Special cameras detect radioactivity, and the images are produced on the computer or on film.

28. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 27 Radiologic Technologist (cont.) Radiation Therapist – Assists radiation oncologists by administering radiation doses. – Works with other staff members to ensure comprehensive treatment of cancer patients.

29. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 28 Radiologic Technologist (cont.) Advanced Practice Roles – Cardiovascular-Interventional Technologist. – Computed Tomography Technologist. – Magnetic Resonance Technologist. – Mammographer. – Sonographer. – Bone Densitometry Technologist. – Quality Management Technologist.

30. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 29 Radiologic Technologist (cont.) Job Responsibilities – Maintains aseptic and sterile techniques and standard precautions. – Transports clients to the radiology department. – Ensures proper identification of the client. – Assists clients as necessary.

31. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 30 Radiologic Technologist (cont.) Job Responsibilities (cont.) – Explains the procedure in a courteous and professional manner. – Operates all equipment and accessories in a clean and efficient manner. – Positions clients for the desired anatomy to be imaged or irradiated.

32. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 31 Radiology Aide Helps members of the radiology team by: – Transporting clients. – Keeping equipment and rooms clean. – Answering phones. – Filing. – Developing films.

33. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 32 Section 26-1 Apply Your Knowledge Name at least four fields of radiology including advanced practice areas. Answer: 1.Nuclear medicine technology. 2.Radiation therapy technology. 3.Mammography. 4.Sonography. 5.Quality management technology.

34. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 33 Procedures in Radiology and Radiologic Technology 26-2 Radiation Protection

35. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 34 Radiation Protection Perform the procedure correctly the first time. Use X-ray film processing techniques that rely on the time, temperature, and specific activity of chemistry methods. Use lead-shielding equipment.

36. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 35 Collimate to the part of the body requiring exposure. Use the correct film size. Use the fluorescent screen-film combination that provides adequate detail at the lowest exposure possible. Use proper filtration, collimation, and exposure techniques. Radiation Protection (cont.)

37. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 36 Use a protective barrier between the operator and source of radiation. Maintain a safe distance of at least 6 feet from the source of radiation. Wear a radiation badge that monitors exposure. Work within established exposure guidelines. Radiation Protection (cont.)

38. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 37 Section 26-2 Apply Your Knowledge Summarize the Inverse Square Law. Answer: The Inverse Square Law states that the intensity of radiation varies inversely with the square of the distance from the source.

39. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 38 Procedures in Student Text 26AAdult Posterior-Anterior (PA) Chest Radiographic

40. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 39 Additional Procedures in Lab Activity Manual LM26-1Adult PA Chest Radiographic Film Evaluation Procedure

41. Copyright © The McGraw-Hill Companies, Inc. Chapter 26 40 Chapter 26 Credits Slide 6Mug Shots/CORBIS Slide 10Scott Camazine/Photo Researchers Slide 13Yoav Levy/PhotoTake NYC Slide 16Pete Saloutos/CORBIS Slide 17(left) Doug Martin (right) Paul Shambroom/Photo Researchers Slide 18(left) Paul Barton/CORBIS (right) Mug Shots/CORBIS Slide 23Bettmann/CORBIS Slide 24Ouelette/Theroux/Publiphoto/Photo Researchers Slide 25(left) Mediscan/Visuals Unlimited (right) CNRI/SPL/Photo Researchers Slide 28(top) Peter Beck/CORBIS (bottom) Steve Chenn/CORBIS Slide 34Jack Plekan/Fundamental Photograph