An Introduction To Radiology


In the medical field, you will encounter numerous terms that might be mind boggling especially if you visit the hospital for a treatment and get results written down. Let's not talk about the famous doctor's handwriting (story for another day) but the terms! Terminologies used can leave you wondering why someone would complicate your life more when you're already in trouble and need help. Well, it's life, but we're here to assist, call us the medical assistants 🙂

Today we'll take a look at a terminology frequently used when you visit the hospital to get yourself checked, not the tests you do by giving samples of you-know-what, but a deeper look into your organs and body tissues. Radiology, heard of it before, right? Well, radiology is a branch of medicine that uses medical imaging to diagnose and treat diseases within the bodies of animals, including humans. It is the science dealing with X-rays and other high-energy radiation, especially the use of such radiation for the diagnosis and treatment of disease. It represents the medical discipline that deals with radiant energy. This field can be divided into two different areas; diagnostic radiology and interventional radiology.

When you visit the hospital for these diagnosis, you get to work with the radiologist. A radiologist is a medical doctor who specializes in diagnosing and treating disease and injury, using medical imaging techniques such as x-rays, computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, positron emission tomography (PET), fusion imaging, and ultrasound.


History of Radiology

In 1895, Wilhelm Conrad Röntgen was a Professor at Wuerzburg University in Germany.  One time, Wilhelm was working in a darkened laboratory. He noticed that a screen painted with a fluorescent material in the same room started to fluoresce or glow. But this was happening a couple of feet away from a cathode ray tube he had energized and had made lightproof. The screen was responding to the nearby production of unknown rays transmitted invisibly through the room. From this observation, he called these conventional radiographic images, “X-rays”. Since that time, radiographic images began to be created, starting as a burst of ionizing radiation and causing a contrast image on a piece of film. Röntgen was honored with the first Nobel Prize in Physics in 1901 because of this discovery.

X-rays are a very energetic form of electromagnetic radiation that can be used to take images of the human body. These X-rays are produced by a combination of ionizing radiation and light striking a photosensitive surface, which in turn produces a latent image that is subsequently processed. According to Kelly Gaffney, X-rays can be produced on Earth by sending a high-energy beam of electrons smashing into an atom like copper or gallium.

In February 1896 a child who had been accidentally shot in the head was brought to the laboratory at Vanderbilt University (Tennessee, USA). Before attempting to locate the bullet in the child, Professor Daniel and Dr Dudley decided to undertake an experiment. Dr Dudley, with his characteristic devotion to science, lent himself to this experiment. A plate holder containing the sensitive plate was tied to one side of Dudley's head and the tube attached to the opposite side of the head. The tube was placed 0.5 inches away from Dudley's hair and activated for 1 hour. After 21 days all the hair fell out from the space under discharge, which was approximately 2 inches in diameter.

Early radiologists were not concerned about the potential negative effects of X-rays. In 1904, protective measures were introduced after the death of Clarence Dally due to metastatic carcinoma caused by heavy radiation (X-ray) exposure. Dally was 39 years at the time and was the long-time assistant of Thomas Edison in X-ray manufacture and testing. People were amused with this invisible ray that has the ability to pass through solid matter, and, in conjunction with a photographic plate, provide a picture of bones and interior body parts. Scientists as well were captured by the demonstration of a wavelength shorter than light. This generated new possibilities in physics, and for investigating the structure of matter.


Diagnostic Radiology

Diagnostic radiology helps health care providers see structures inside your body. Doctors that specialize in the interpretation of these images are called diagnostic radiologists. Using the diagnostic images, the radiologist or other physicians can often: Monitor how well your body is responding to a treatment you are receiving for your disease or condition and screen for different illnesses, such as breast cancer, colon cancer, or heart disease.

Fluoroscopy is an imaging technique that uses X-rays to obtain real-time moving images of the interior of an object represents a modality where X-rays are used in performing real-time visualization of the body, allowing for evaluation of body parts, administered contrast flow and positioning changes of bones and joints. Radiation doses in fluoroscopy are substantially higher when compared to conventional radiography, as many images are acquired for every minute of the procedure.

Computed tomography (CT) is a medical imaging procedure that uses computer-processed combinations of many X-ray measurements taken from different angles to produce cross-sectional images of specific areas of a scanned object, allowing the user to see inside the object without cutting. It currently represents the workhorse of radiology. Recent developments permit extremely fast volume scans that can generate two-dimensional slices in all possible orientations, as well as sophisticated three-dimensional reconstructions. Nevertheless, the radiation dose remains high, thus a very strict indication for every intended CT is needed.

Ultrasonography is a technique using echoes of ultrasound pulses to delineate objects or areas of different density in the body. It is still the cheapest and most harmless technology in radiology, which is the reason why many physicians outside radiology use this technique. Ultrasound probes utilize acoustic energy above the audible frequency of humans in order to produce images. As there is no ionizing radiation with this modality, it is particularly useful in imaging of children and pregnant women.

Nuclear medicine  is a medical specialty involving the application of radioactive substances in the diagnosis and treatment of disease. Nuclear medicine images are made by giving the patient a short-lived radioactive material, and then using gamma camera or positron emission scanner that records radiation emanating from the patient. Most common nuclear medicine modalities used in clinical practice are single-photon emission computed tomography (SPECT) and positron emission tomography (PET).

Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. It makes use of the potential energy stored in the body’s hydrogen atoms. Those atoms are manipulated by very strong magnetic fields and radiofrequency pulses to produce adequate amount of localizing and tissue-specific energy that will be used by highly sophisticated computer programs in order to generate two-dimensional and three-dimensional images. The major advantage is that no ionizing radiation is used.


Interventional Radiology

Interventional radiology procedures include:

Gastrostomy insertion is the placement of a feeding tube through the skin and the stomach wall which goes directly into the stomach.

Tumor ablation is a minimally invasive technique that is commonly used in the treatment of tumors of the liver, kidney, bone, and lung with radiofrequency ablation, cryoablation, or microwave ablation.

Vertebroplasty is an outpatient procedure for stabilizing compression fractures in the spine. Bone cement is injected into back bones (vertebrae) that have cracked or broken. The cement hardens, stabilizing the fractures and supporting your spine.

Kyphoplasty  is a vertebral augmentation surgery to treat fractures in the vertebra. These fractures may occur because of conditions such as osteoporosis or trauma.

Needle biopsies of different organs. Biopsy is the removal of a small piece of tissue such as the lungs and thyroid gland for laboratory examination. Breast biopsy, guided either by stereotactic or ultrasound techniques.

Angiography or angioplasty and stent placement is the procedure that is used to treat a carotid artery (blood vessels that bring blood to your brain and face) that is narrowed or blocked. The blood flow in this artery can become partly or totally blocked by fatty material called plaque. A partial blockage is called carotid artery stenosis (narrowing). A blockage can reduce the blood supply to your brain. and might cause a stroke.

Venous access catheter placement is a procedure where the catheter is inserted through the skin and into a vein (in the neck, arms or legs) and the tip of the catheter is positioned into a large central vein that drains near the heart using as ports and PICCs.

Embolization refers to the passage and lodging of an embolus within the bloodstream . It's an endovascular procedure that prevents blood flow to an area of the body, which can effectively shrink a tumor or block an aneurysm. Cancer treatments including tumor embolization using chemoembolization, Y-90 radioembolization or uterine artery embolization. These treatments are meant to to control bleeding.


Role of a Radiologist

He is also responsible for treating diseases by means of radiation energy or minimally invasive, image-guided therapeutic intervention.

A radiologist acts as an expert consultant to your referring physician by helping them in choosing the proper examination.

He also takes part in interpreting the resulting medical images, and using test results to diagnose your treatment.

Guiding personnel who operate the equipment in the proper performance of quality tests.

Recommending further appropriate examinations or treatments when necessary and conferring with referring physicians.

Comparing and contrasting medical image findings with other examinations and tests.


Health Concerns

The science of radiation protection, or "health physics" as it is more properly called, grew out of the parallel discoveries of X-rays and radioactivity in the closing years of the 19th century. Experimenters, physicians, laymen, and physicists alike set up X-ray generating apparatuses and proceeded about their labors with a lack of concern regarding potential dangers. Such a lack of concern is quite understandable, for there was nothing in previous experience to suggest that X-rays would in any way be hazardous.

Today, it can be said that radiation ranks among the most thoroughly investigated causes of disease. Although much still remains to be learned, more is known about the mechanisms of radiation damage on the molecular, cellular, and organ system than is known for most other health stressing agents. Indeed, it is precisely this vast accumulation of quantitative dose-response data that enables health physicists to specify radiation levels so that medical, scientific, and industrial uses of radiation may continue at levels of risk no greater than, and frequently less than, the levels of risk associated with any other technology.

If the irradiated matter is living tissue, the breaking of chemical bonds may result in altered structure or a change in the function of cells. During early experiments with exposures to radiation there were sunburns, loss of limbs and even lives. Men and women researchers collected and documented information on the interaction of radiation and the human body. This early information helped science understand how electromagnetic radiation interacts with living tissue. Unfortunately, much of this information was collected at great personal expense.




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