1 CAREERS IN RADIOLOGIC TECHNOLOGY (FINAL) RADIOLOGIC TECHNOLOGIST –RADIOGRAPHER –X-RAY TECHNOLOGIST “ TECHNICIAN” –Limited License RADIOLOGIST –Medical doctor

2 What does a Radiologic Technologist do?

3 A “Radiologic Technologist” (or Radiographer) Medical Professional –In a challenging field Safely uses x-rays to image anatomy –Positions –Using sophisticated technology –Practices radiation protection Provides quality-diagnostic images –Assists DR –Communicates with patient –Practices patient privacy

4 Registered Technologist R.T. Dawn Charman, M.Ed., RT (R)(M), CRT(R)(F) Kelly Clark, M.S.R.T. RT (R)(CT), CRT(R)(F) Mina Colunga, B.S.R.T. RT (R), CRT(R)(F) ARRT – R.T. State of California– C.R.T.

5 Radiologic Technologist ECC program is for an entry level into the profession Radiation Therapy and Nuclear Medicine would require additional education Certification/licenses ARRT- American Registry of Radiologic Technologies –Provides national certification CRT-- California Registered Technologist –After completing ARRT exam you pay a fee and get your California license to practice –A separate test is taken for fluoroscopy

6 Certification vs. License ARRT –National certification R.T. –Must take an exam Pass with 75% –Can take this after completing program CRT –State Licensing –Must pass ARRT exam to get this –Pay fee to get radiography license (R) –Take fluoroscopy exam and pay a fee for (F) license

7 All types of EXAMS & PEOPLE Infants Elderly All classes All ethnicity All backgrounds Head to toes Trauma Special procedures Critical patients Walk ins Surgery

8 FIG. 4–2 Radiologic science professionals must use advanced critical thinking skills when handling all patient care situations. Elsevier items and derived items © 2007, 2003 by Saunders, an imprint of Elsevier Inc. Radiologic Technologist Must be able to communicate effectively with: Patients, staff, & peers Must use: good judgment Critical thinking skills

9 Critical Thinking Involves sound, professional judgment Applied with high ethical standard And integrity

10 Critical Thinking Analysis Synthesis Evaluation Critique Achieved through –Role Playing –Lab experiments –Case Studies

11 Patient Communication Interacting with the patient Interacting with family and friends Methods of Effective Communication Age as a factor in Patient Interactions

12 Communication & Adapting to Special Condition Patients Traumatized Patients Visually Impaired Patients Speech and Hearing Impaired Patients Non-English Speaking Patients Mentally Impaired Patients Substance Abusers

13 Education in the Radiologic Sciences at ECC Didactic Curriculum (lecture) –Specifically describes the objectives –What the students will learn –How they will learn (instructional activities) Clinical –Hospital training –Apply didactic principals to clinical setting

14 FIG. 5–1 The articulation of didactic, laboratory, and clinical instruction. (From Ford C, ed: Clinical education for the allied health professions, St Louis, 1978, Mosby.) RT Programs Didactic and Clinical Education

15 Types of Diagnostic Exams Chest Extremities Skull/ Facial Spine Gastrointestinal Interventional

16 LEARNING COGNITIVE – –thought / knowledge PSYCHOMOTOR – – physical actions AFFECTIVE – –guided by feelings

17 Some studies of spinal trauma have recorded a missed injury rate as high as 33%.

18 ComminutedOpen

19 ELDERLY

20 INFANTS & CHILDREN

21 SURGERY

22 Fluoroscopy

23 TECHNOLOGIST FLUOROSCOPY Dawn Charman RT (R), (F) CONTRAST MEDIA (X-RAY DYE)

24

25

26 ARRT Standards Accrediting Agencies Joint Review Committee on Educational Programs in Nuclear Medicine Technology (JRCNMT) Committee on Accreditation of Allied Health Education Programs (CAAHEP) in collaboration with the Joint Review Committee on Education in Diagnostic Medical Sonography (JRC-DMS) Regional Institutional Accrediting Agencies (degree-granting divisions) WSAC Conjoint Accreditation Services of the Canadian Medical Association Australian Institute of Radiography

27 Accrediting Agencies SCHOOLS/PROGRAMS JRCERT: Joint Review Committee on Education in Radiologic Technology HOSPITAL ACCREDITATION JCAHO :Joint Commission on Accreditation of Healthcare (Hospital) Organizations

28 “Alphabet Soup” NATIONAL & STATE LICENSES ARRT = (R.T.) American Registry of Radiologic Technology R.T. – Certification in Radiologic Technology CRT – Certified Radiologic Technology State of California, Dept of Health - Radiation Health Branch –Licensing to practice in California C.R.T. (R) (F) (M) Radiography, Fluoroscopy, Mammography

29 5 Primary Exams Radiography (R) Nuclear Medicine Technology (NM) Radiation Therapy (T) Sonography (US) (RDMS) Magnetic Resonance Imaging (MR)

30 Post Primary Cardiovascular- Interventional Radiography (CVIT) –Note: No longer available for new candidates Mammography (M) Computed Tomography(CT) Magnetic Resonance Imaging (MR) or (MRI) –Note: Both a primary and post- primary track Quality Management (QM) Sonography (US) or (RDMS) –Note: Both a primary and post- primary track Bone Densitometry (BD) Vascular Sonography Cardiac-Interventional Radiography (CI) Vascular-Interventional Radiography (VI) Breast Sonography Registered Radiologist Assistant (RA)

31 “Alphabet Soup” KNOW THESE! J.R.C.E.R.T - Joint Review Committee on Education in Radiologic Technology J.C.A.H.O – Joint Commission of Accreditation of Healthcare Organizations A.R.R.T- American Registry of Radiologic Technologists

Beyond Diagnostic Radiography Advanced Modalities

33 ADVANCED SKILL LEVELS CAT SCAN (CT) MRI (MR) ANGIOGRAPHY (CIT) (CV) RADIATION THERAPY (T) MAMMOGRAPHY (M) Bone Densitometry (BD) ULTRASOUND (RDMS) NUCLEAR MEDICINE(NM) –PET –SPECT MANAGEMENT (BS) EDUCATION (BS,MEd, PhD EDD)

MAMMOGRAPHY Dawn Charman, RT (M) RADIOGRAPHIC IMAGING OF THE BREAST Diagnostic for breast cancer

35

36 Bone Densitometry “low dose Radiation”

37 BONE DENSITOMETRY JOE RUIZ, RT (R) (BD) POST PRIMARY EXAM BEGAN IN JANUARY 2001 ??? May also have certification w/o RT ???? MEASURING MINERAL CONTENT AND DENSITY OF BONES

38 FIG. 1–7 A nuclear medicine technologist performs procedures requiring the use of radioactive substances. (Courtesy of Philips Medical Systems.)

39 CAT SCAN & MRI

40 Computed Tomography Kelly Clark, RT (R) (CT) 1995 began post primary exam

41 FIG. 1–9 A computed tomographic technologist uses a computerized x-ray system to produce sectional anatomic images of the body. (Courtesy of Philips Medical Systems.) CT SCANNER USES RADIATION – AND A COMPUTER TO RECONSTRUCT IMAGES 3-D

42 C T SCANNER

43

Electron Beam Tomography EBT WHOLE BODY SCANNER

45 Risk factor HIGH DOSES ? WHAT YOU DON’T KNOW ……. ‘FALSE POSITIVE’S” NOW THAT YOU KNOW – WHAT ARE YOU GOING TO DO ABOUT IT? =

46 Radiation Dose EBT scans expose the patient to about 1/5th the radiation of a multi-slice CT scanner. OR so they tell you.. $$$$$$$$

47 Magnetic Resonance Imaging RT (R) (MRI) or RT (T) (MRI) or (N) (MRI) 1995 ARRT began post primary exams

48 MRI SIGNAL PRODUCTION Images are crated by interaction of Magnet field, radio waves with tissue Atoms – Nucleus – Electrons

49

50 MRI SAFETY USE NON MAGNETIC MATERIALS CAN CAUSE HARM TO PATIENT & PERSONELL 1 REPORTED DEATH FROM O2 TANK & 6YO PATIENT

51 MRI NOT IONIZING RADIATION USES MAGENTIC RESONANCE (RADIO WAVES) Jane Schultz, R.T. (MR)

52

53

54

55 RADIOGRAPHY VS MRI BONE vs. Soft Tissue

56 PET Scan & SPECT Scan PET = Positron Emission Tomography Single Photon Emission Computed Tomography X-rays/MRI with Radioisotopes

57

58

59 PET Scan showing diffuse spread of prostate cancer to bone. PET has the advantage over traditional bone scanning in its ability to differentiate active from dormant disease.

60

ANGIOGRAPHY/ CARDIOVASCULAR INTERVENTIONAL TECHNOLOGY is a specialized radiographic examination where the images of the blood vessels of the body are demonstrated by injection of contrast media.

62 CARDIAC-INTERVENTIONAL RADIOGRAPHY Mike Smith, RT (R) (CI) POST PRIMARY EXAM BEGAN IN JANUARY 2003

63 INTERVENTIONAL RADIOGRAPHY ANGIOGRAPHY CARDIAC CATH + MANY OTHERS RT (CV) (CIT) (CVIT)

64 ANGIOGRAPHY is a specialized radiographic examination where the images of the blood vessels of the body are demonstrated by injection of contrast media

65 Cardiovascular Interventional Radiography Jane Smith, RT (R) (CVI) Angiography 1991 began post primary exam for CVIT Radiographers

66

67 Angiography of Heart vessels ww.nhlbi.nih.gov/health/dci/images/stent_resten osis.gif&imgrefurl= h/dci/Diseases/stents/stents_all.html&usg=__xDl bsaX9JhuYbpVojLcz19apr- I=&h=513&w=450&sz=59&hl=en&start=20&tbnid =vWwqaG-RNW7M- M:&tbnh=131&tbnw=115&prev=/images%3Fq% 3Dabdominal%2Bstents%26gbv%3D2%26hl%3 Denhttp://images.google.com/imgres?imgurl= ww.nhlbi.nih.gov/health/dci/images/stent_resten osis.gif&imgrefurl= h/dci/Diseases/stents/stents_all.html&usg=__xDl bsaX9JhuYbpVojLcz19apr- I=&h=513&w=450&sz=59&hl=en&start=20&tbnid =vWwqaG-RNW7M- M:&tbnh=131&tbnw=115&prev=/images%3Fq% 3Dabdominal%2Bstents%26gbv%3D2%26hl%3 Den

68 Angiography

69 VASCULAR-INTERVENTIONAL RADIOGRAPHY JOE CAR, RT (R) (VI) POST PRIMARY EXAM BEGAN IN JANUARY 2003

70

71 71

72 NUCLEAR MEDICINE use radioactive isotopes to make images

73 Nuclear Medicine RT (NM) ARRT or NMTCB

74 NM – Images collected after injections of a RADIOISOTOPE

75 The tracer travels into the blood vessels until it arrives to the bone

76 PET Scan & SPECT Scan PET = Positron Emission Tomography Single Photon Emission Computed Tomography

77

78 Prostate cancer metastasized in bones

79 PET NUCLEAR MED + CT or MRI- co-registration

80

81

82

83 RADIATION THERAPY R.T.(T) 2 YRS ADDITIONAL EDUCATION CITY OF HOPE LLU CAL STATE LONG BEACH The branch of Radiology that involves the treatment of disease by means of high energy x-rays or radioactive substances

84

85

86 RADIATION THERAPY branch of Radiology that involves the treatment of disease by means of high energy x-rays (GAMMA) or radioactive substances

87 Radiation Therapy RT (T) = Registered technologist in radiation therapy technology Medical dosimetrists are involved in treatment planning and dose calculations 1-4 year program

88

89 ULTRASOUND uses a technique similar to Navy SONAR to produce diagnostic images.

90 ULTRASOUND Cypress College Orange Coast LLU 1 – 2 years

91 Diagnostic Medical Sonographers RT (R) (S) or RT (S) or (RDMS) American Registry of Diagnostic Medical Sonographers ARRT in 1999 began post primary exam ARRT in 2005 began primary exam

92 Determines depth Ultrasound beam is transmitted and reflected – as special crystal at the end of the transducer can determine the type of tissue

93 Uses SOUND WAVES (NOT X-RAYS) “real time” images

94 ULTRASOUND uses a technique similar to Navy SONAR to produce diagnostic images.

95 19 Week fetus mbryology.med.unsw.edu.au/movies/usound/19 weeklabel2.jpg&imgrefurl= d.unsw.edu.au/movies/usound/Hum19w4D.htm& usg=__EfDiZ2qdLFEQ_ZGPy9YS628QyPI=&h= 379&w=358&sz=11&hl=en&start=71&tbnid=QqS TbyckVI- jYM:&tbnh=123&tbnw=116&prev=/images%3Fq %3Dfetal%2Bultrasound%26gbv%3D2%26ndsp %3D20%26hl%3Den%26sa%3DN%26start%3D 60

96

97

98

99 2D vs. 3D/4D

100 U/S & the “real thing”

101 Breast Sonography Post Primary Exam Valuable for Technologists that specialize in Mammography

102 VASCULAR ULTRASOUND

103 New - RA Radiology Assistant (Like PA) Weber State (On line – Utah) LLU 3 others in US (2007 – more) $$$$ NEW GRADS = 100 K/YEAR (?) PART OF RADIOLOGIST GROUP As of 2007 – NOT APPROVED BY STATE to Work as RA in California

104 Additional Opportunities Education Administration Management (QM) Commercial Radiologist Assistant = RA

105 RADIOLOGY ASSISTANT RA LLU 2 YRS RT BA DEGREE WEBER STATE 6YR RT

106 OTHER PATHWAYS SALES APPLICATIONS SPECIALIST INDUSTRIAL X-RAY MANAGEMENT (DEGREE) EDUCATON

107 TRAVELING TECHNOLOGIST = SEE THE WORLD AND GET $$$

108 Other working opportunities… Registry (local) Registry (out of state) X rays taken around the world !!

109 Variety of Work Settings physicians offices, clinical outpatient facilities, free standing imaging centers, mobile imaging centers portable services to rehabs Mammo’s to under privileged areas Urgent care

110 SALARY RANGES RT’s NEW R.T. = $ 25 -$38 PER HOUR ON-CALL + O.T. $45,000 – $60,000 YR ADVANCE SPECIALTIES $ 30 - $50 PER HOUR A GREAT SHORTAGE IN ALL HEALTH CARE – A GREAT NEED TO AQUIRE NEW TECHNOLOGIST TO THIS AREA

111 Professional Organizations ASRT – American Society of Radiologic Technologist CSRT – California Society Society of Radiologic Technologists RTEC – Radiologic Technology Educators of California International Societies, other state societies, other modalities