CHAPTER 23 IMAGING CAREERS Echocardiography Isotope Radiographic contrast

CHAPTER 23 IMAGING CAREERS Echocardiography Isotope Radiographic contrast media Radiography Ultrasound Fluoroscopy Polarity Tomography Journal question: What personal characteristics might make a student a good candidate for a career in diagnostic imaging? Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 1

Chapter 23 Learning Objectives Define at least seven terms relating to careers in medical imaging. Specify the role of selected diagnostic medical health care workers, including personal characteristics, levels of education, and credentialing requirements. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 2

Chapter 23 Learning Objectives Discuss three important developments in the field of diagnostic imaging. Identify one imaging technique that does not use radiation. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 3

Imaging Careers Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 4

Imaging Career: Educational Costs and Earnings Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 5

Medical Imaging Radiologic technologist (radiographer) Works under the direction of a radiologist Transfers and positions patient Selects the proper technical factors to ensure quality of radiograph Ø Administers dye to make the internal body parts visible Ø Education Ø Ø Ø • 2 years of education is average • 38 states require certification Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 6

Radiology Job Opportunities Radiology job opportunities are found in hospitals, radiologic services of physicians’ offices, and privately owned facilities. Radiologic jobs involve some hazard of radiation exposure. Ø Workers wear a film badge that records the level of exposure to radiologic materials. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 7

Radiology Job Opportunities Educational requirements Ø Strong background in human anatomy and physiology Ø Programs of study • Requires 1 to 4 years (2 years is the most common) • Radiology technologists are required to have a college or university degree. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 8

Radiologic Specialties Nuclear medicine technologist (NMT) Prepares and administers radioactive compounds Ø Participates in research activities Ø Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 9

Diagnostic Nuclear Medicine Diagnostic nuclear medicine scans are obtained for the Heart Ø Brain Ø Thyroid Ø Lung Ø Bone Ø Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 10

Radiologic Specialties Ultrasound technologist Obtains two-dimensional images of internal organs Ø Specialties Ø • Obstetrics and gynecology • Abdominal ultrasound studies • Neurosonography Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 11

Medical Imaging Radiologic physicist Assists a physician with the care of patients, equipment selection, quality control, teaching, and radiation safety Ø Education Ø • Master’s degree or doctorate in medical physics or a related discipline • A 2 - to 3 -year postgraduate program or clinical medical physics residency program • Certification by the American Board of Radiology Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 12

Medical Imaging Medical dosimetrist Works under the supervision of a medical physicist Calculates and plans radiation doses to treat cancer Ø Education Ø Ø • Varies but must include mathematics and physics Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 13

Content Instruction Electrocardiogram (ECG) technician Attaches electrode leads or pads on the patient to monitor or test the action of the heart Ø Education Ø • Community college or vocational program or on-thejob training • Specialized training Cardiac catheterization Echocardiography Continuous monitoring Blood flow studies Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 14

Medical Imaging Electroencephalographic (EEG) technologists Measure the electrical activity of the brain to aid in diagnosis of disorders • Place electrode instrument on patient • Monitor patient during testing • Adjust EEG machine Ø Education • 1 to 2 years of training • May seek registration after completing program Ø Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 15

Content Instruction Roentgen discovered x-rays in 1895. Contrast agents were developed by pharmacists. By the 1950 s, radioactive isotopes were being used to diagnose disorders. Currently, more than 100 tests use radiographs. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 16

Content Instruction Mammography Ø Radiograph of the breast to detect cancer • Interpreted by a radiologist • Digital mammography: technique for recording radiograph images in computer code Allows examination of all areas of the breast with various tissue densities Computed tomography (CT) Links the use of computers with radiographic procedures Ø Provides cross-sectional views of the whole body instead of just one region Ø Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 17

Content Instruction Positron emission tomography (PET) PET scan shows the metabolic activities of the body and its structure. Ø Radioactive biochemical (glucose or nitrogen) is inhaled or ingested by the patient. Ø • Computer produces colored images that depend on the amount of gamma rays produced. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 18

Content Instruction Magnetic resonance imaging (MRI) MRI uses a strong magnetic field, radio waves, and a computer but does not use ionizing radioactivity. Ø The nuclei of some atoms (e. g. , hydrogen) in cells align with the magnetic field. Ø Applied radiofrequencies bounce off in particular ways and are interpreted by the computer to produce detailed pictures (images). Ø It is used for diagnosing brain and spine pathology. Ø MRI can be done with the patient in an open or closed machine. Ø Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 19

Magnetic Resonance Imaging FIGURE 23 -5 A magnetic resonance imaging machine. (Courtesy Siemens Medical Systems, Malvern, Pa. ) Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 20

MRI of Lymph Nodes FIGURE 23 -6 Three dimensional MRI of the lymph nodes. (From Patton KT, Thibodeau GA: Anatomy & Physiology, ed 7, St. Louis, 2010, Mosby. ) Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 21

Correct Positioning FIGURE 23 -8 Correct positioning is important to ensure that radiographs provide the best image possible. A, Chest. B, Spine. C, Chest. D, Ankle. (Courtesy Swissray International Inc. , Elmsford, N. Y. ) Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 22

Content Instruction Near-infrared spectroscopy (NIRS) Ø Technique that allows noninvasive measurement of cerebral functions • Spectrograph detects the near-infrared light that penetrates the skull and brain Digital radiography (DR or DX) Ø Emerging technique used to reduce time needed for and the expense of processing film • Contrast is better Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 23

Content Instruction Bone density scans, or dual-energy x-ray absorptiometry (DXA or DEXA) Enhanced x-ray method used to detect bone loss Ø Performed on the lower spine and hips Ø Interventional radiology Ø Small tubes or catheters are inserted into the blood vessels to correct abnormalities. • In balloon angioplasty, radiographic contrast media is injected into diseased arteries to see vascular structures. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 24

Performance Instruction Imaging involves use of radiation Exposure is monitored and regulated by federal government. Ø Entry-level workers do not usually participate directly with procedures that require radiation. Ø Radiography assistants help to move or position patients for examinations or treatments involving radiation. Ø Assistants may also perform loading and processing of films. Ø Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 25

Summary Medical imaging careers include the radiologist, nuclear medicine technologist, and sonographer. Workers in medical imaging must be reliable, have mechanical aptitude, and possess good communication skills. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 26

Summary Developments in diagnostic imaging include near-infrared spectroscopy, digital radiology, and interventional radiology. One imaging technique that does not use ionizing radiation is MRI. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 27

Review An echocardiograph is: a. A record or image of a plane of the body b. A record or image of a blood vessel c. A record or image of the heart and blood vessels made with ultrasound d. A record or image made with sound waves e. A record or image of the breast Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 28

Review An echocardiograph is: a. A record or image of a plane of the body b. A record or image of a blood vessel c. A record or image of the heart and blood vessels made with ultrasound d. A record or image made with sound waves e. A record or image of the breast Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 29

Review A mammogram is: a. A record or image made using sound waves b. A record or image of a plane of the body c. A record or image of a blood vessel d. A record or image of the breast e. A record or image of the heart made using ultrasound Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 30

Review A mammogram is: a. A record or image made using sound waves b. A record or image of a plane of the body c. A record or image of a blood vessel d. A record or image of the breast e. A record or image of the heart made using ultrasound Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc. , an affiliate of Elsevier Inc. 31