RAD TECH A WEEK 2 CAREER’S IN RADIOLOGY RADIOGRAPHIC EQUIPMENT Spring 2009

HISTORY REVIEW WHO WHAT WHEN

The discovery of X rays by the German physicist Wilhelm Roentgen in 1895 was an international sensation. Working with vacuum tubes, he bombarded a metal plate with high speed electrons. He found that invisible rays were produced. These mysterious new rays could go through skin and flesh and give a picture of a person's bones.

Collaborative Events  Crookes tube Air evacuated glass tube Air evacuated glass tube Cathode side Cathode side Anode side Anode side Electrical supply Electrical supply  Screen or board painted with barium platinocyanide  Low light work area

X-rays – the Basic Radiological Tool Roentgen’s experimental apparatus (Crookes tube) that led to the discovery of the new radiation on 8 Nov – he demonstrated that the radiation was not due to charged particles, but due to an as yet unknown source, hence “x” radiation or “x-rays” Known as “the radiograph of Bertha Roentgen’s hand” taken 22 Dec. 1895

Hand images Today !

“Willie Roentgen” Honored in 1901 with the first Nobel prize in physics for his efforts.

X-ray production begins at the atomic level Energy (photons) are released when the electron collides with another electron, the change in e of the shells –produces photons More on this in week 4 !

CAREERS IN RADIOLOGIC TECHNOLOGY RADIOLOGIC TECHNOLOGIST –RADIOGRAPHER –X-RAY TECHNOLOGIST TECHNICIAN RADIOLOGIST

Objectives Define the Radiology Team Illustrate Careers in and around Radiology Identify work environments for Imaging Technologists

What does a Radiologic Technologist do?

Radiologic Technologist Help others Help others Work with people Work with people Make a difference Make a difference Think critically Think critically Demonstrate creativity Demonstrate creativity Achieve results Achieve results

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 JUDGEMENT & CRITICAL THINKING SKILLS

Practices RADIATION SAFETY TO SELF & OTHERS

Early years in Radiologic Technology Nurses or nurses aides taught how to “take an x-ray” NO special education Only “ON THE JOB” training Experience the best teacher The first Technologist is credited to be EDWARD C. JERMAN.

ARRT arrt.org 275,000 Registered RT (R) 2007: 15,285 exams –89% Radiography – 3.6 % Nuclear Med –7.1 Radiation Therapy NATIONAL LICENSURE

Consumer Assurance of Radiologic Excellence The (CARE) bill would ensure that patients undergoing all types of radiologic procedures have the same assurance of quality as those receiving mammograms under the provisions of the Mammography Quality Standards Act.

CARE BILL Consistency, Accuracy, Responsibility, and Excellence... ARRT Among Supporters Seeking To Ensure Patient Safety Through Adoption of CARE Bill ASRT – American Society of Radiologic Technologist ASRT.org

As of Sept states have no licensure laws

Diagnostic Radiologic Technologist Aka: Radiographer Not a “Technician”

Types of Diagnostic Exams CHEST EXTREMITIES SKULL / FACIAL SPINE GASTROINTESTINAL

Trauma Mobile

“TRAUMA”

ALL PATIENTS

ELDERLY

INFANTS & CHILDREN

UNIQUE, UNUSAL, INTERESTING, ETC

SURGERY

TECHNOLOGIST FLUOROSCOPY CONTRAST MEDIA (X-RAY DYE) KELLY HOLT, ARRT R.T. (R)

FLUOROSCOPY- XRAYS IN MOTION

Fluoroscopy Gastrointestinal Exams

ARRT Exams Primary Examinations Five “Primary Exams” offered by the ARRT

5 Primary Exams Radiography (R) Nuclear Medicine Technology (NM) Radiation Therapy (T) Sonography (US) (RDMS) Magnetic Resonance Imaging (MR) candidates must have successfully completed a formal educational program in the respective discipline that is accredited by a mechanism acceptable to ARRT.

Beyond Diagnostic Radiography Advanced Modalities

POST – PRIMARY EXAMS (TAKEN AFTER COMPLETIONS OF ARRT – RT License)  (M) Mammography  (CT) Computed Tomography  (MRI) Magnetic Resonance Imaging  (QM) Quality Management  (US) Sonography Vascular Sonography  Breast Sonography  (BD) Bone Densitometry  (CV) Cardiac-Interventional Radiography  (CIV) Vascular-Interventional Radiography

Advanced Practice  (R.R.A) Registered Radiologist Assistant  Imaging Informatics Certification Program Merging IT and Medical technology Merging IT and Medical technology  PET  MANAGEMENT (BS or BA)  EDUCATION (BS,MEd, PhD EDD)

Another way to categorize medical imaging Ionizing  Diagnostic  Fluoroscopy  Special Procedures:  Interventional  Angiography  Cardiac Cath  CT  Mammography  Bone Densitometry  Nuclear Medicine  Radiation Therapy Non Ionizing  Ultrasound Sonography Sonography  MRI

HEALTH CARE TEAM  MEDICAL CENTER  RADIOLOGY  RADIOLOGIST  TECHNOLOGIST VS TECHNICIAN  RADIATION

RADIATION  ENERGY  IONIZATION- adding or removing an electron  IONIZING RADIATION  NON-IONIZING RADIATION

What is Ionization?

When an electron is added or removed from the atom- it is ionized

Another way to categorize medical imaging Ionizing Diagnostic Fluoroscopy Special Procedures: Interventional Angiography Cardiac Cath CT Mammography Bone Densitometry Nuclear Medicine Radiation Therapy Non Ionizing Ultrasound Sonography MRI

MAMMOGRAPHY Colleen McFaul, RT (R) (M) RADIOGRAPHIC IMAGING OF THE BREAST Dx for breast cancer

Mammography RT (R) (M) 1992 began post primary exam for mammographers Uses Ionizing Radiation

Bone Densitometry “low dose Ionizing Radiation”

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

Bone densitometry

CT SCAN & MRI

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

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 Ionizing RADIATION – AND A COMPUTER TO RECONSTRUCT IMAGES 3-D

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

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

MRI EXAMS MRI is growing as an alternative to traditional x-ray mammography.

RADIOGRAPHY VS MRI BONE vs Soft Tissue

NUCLEAR MEDICINE use radioactive isotopes to make images

Nuclear Medicine RT (NM) ARRT or NMTCB

scans use radioactive isotopes to make images

NM – Images collected after injections of a RADIOISOTOPE

PET Scan & SPECT Scan PET = Positron Emission Tomography Single Photon Emission Computed Tomography CT (x-rays) or MRI with Radioisotopes

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.

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

INTERVENTIONAL RADIOGRAPHY Uses Fluoroscopy Ionizing Radiation

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

RADIATION THERAPY R.T.(T) 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

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

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

ULTRASOUND Cypress College Orange Coast LLU 1 – 2 years

FIG. 1–10 A diagnostic medical sonographer uses high-frequency sound waves to create images. (Courtesy of Philips Medical Systems.)

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

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

U/S & the “real thing”

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

VASCULAR ULTRASOUND

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

New - RRA 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

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

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

Work Opportunities Hospital Imaging Center Doctor’s Office Mobile Trailer Research

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

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

TRAVELING TECHNOLOGIST = SEE THE WORLD AND GET $$$

NEED – JOB SECURTIY PEOPLE ARE GETTING OLDER – LIVING LONGER TECHNOLOGIST ALSO GETTING OLDER NEED NEW, YOUNG PEOPLE TO TAKE OVER THE JOBS & TAKE CARE OF THE SICK AND ELDERLY

REVIEW: PRIMARY EXAMINATIONS ? RADIOGRAPHY NUCLEAR MEDICINE TECHNOLOGY RADIATION THERAPY SONOGRAPHY (7/05) MAGNETIC RESONANCE (2006)

Review Radiology Team Patient Care Careers Other Careers Opportunities Work Settings

HISTORY REVIEW WHO WHAT SERIES OF EVENTS WHEN

QUESTIONS?