Radiology And Diagnostic Imaging

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Radiology branch of medicene uses radioactive substances electromagnetic radiation/sound waves create images of body/organs/structures

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Images show how effective the body and internal organs/structures functioning

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radiology discovered 100 years ago evolved high tech science state-of-the-art equipment aid imaging every aspect of body

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concern over potential harmful side effects with radiation believed small risks outweighed by info gained about patients' conditions contribution to med science

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radiology offers diagnostic and therapeutic services

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Diagnostic Radiology****
uses external radiation produce images of body/organs/internal structures for medical diagnostic purposes

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Nuclear Medicene****
very small amounts of radioactive materials create image of body organ functions structure diagnostic and treatment purposes

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Therapeutic RAdiology *****Radiation Oncology
applications of radiant energy study treat manage cancer other diseases

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Interventional Radiology****
various imaging techniques guide insertion of small instruments and tools

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through body identify and treat medical disorder without requiring conventional surgery

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Diagnostic radiology process of creating images of body/organs******/internal structures with external radiation

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diagnostic radiology techniques include
x-ray tubes emit radiation radionuclides ultrasonographic devices radiofrequency electromagnetic radiation

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diagnostic radiology ******techniques non-invasive but certain procedures combine diagnostic radiology tech minimally invasive****** procedures diagnose/treat condition

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different diagnostic scans procedures performed in nuclear****** medicine (small amounts of radioactive agents thallim *******technetium examine organs structure) used to diagnose manage treat medical disorders/diseases

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arteriogram******/angiogram******
x-ray image of blood vessels evaluate vascular conditions aneurysm/ballooning blood vessel stenosis/narrowing blood vessel or blockages

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to obtain x-ray of blood vessel IV access necessary contrast dye injected into circulatory system

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dye causes blood vessels appear opaque on x-ray image to visualize structure of vessel under exam

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arteries of blood examined by arteriogram arterial systems of legs kidneys brain and heart

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barium x-rays
upper lower GI series diagnose abnormalities of GI tract tumors***** ulcers inflammatory conditions polyps hernias strictures uses barium sulfate metallic chemical rays can't pass through rays takesn of area under examination

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computed tomography CT CAT scan
combo of x-rays computer tech produce cross-sectional images slices horizontally vertically***** of body shows detailed images of any part bones muscles fat organs***** more detailed than x-rays also minimize exposure to radiation*******

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conventional x-rays beam of energy aimed at part plate behind part captures variations of energy beam passed through skin about bone muscle tissue no internal organs/structures

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CT scan beam moves in circle around body different views great detail ray info sent to computer interprets data displayed 2-dimensional form on monitor less radiation than singlle x-ray

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CT with/without contrast****** (mouth injected in IV to see organ or tissue) contrast exams must fast before

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CT scans diagnose tumors investigate internal bleeding check internal injuries damage

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fluoroscopy study moving***** body structures x-ray movie continuous ray beam passed through part transmitted to TV-like monitor motion seen

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fluoroscopy used barium x-rays cardiac catheterization IV catheters

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barium rays fluoroscopy see movement of intesstines as barium moves through them

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cardiac catheterization flouroscopy see flow of blood through coronary arteries arterial blockages

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IV catheter insertion fluoroscopy guides catheter specific location insside body

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Magnetic resonance imaging MRI diagnostic procedure combo large magnet radiofrequencies and computer produce images of organs structures within body

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MRI used
examine heart brain liver pancreas male/female reproductive organs soft tissues

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assess blood flow
detect tumors diagnose cancer
evaluate infections
assess injuries to bones/joints

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MRI performed outpatient/inpatient large cylindrical tube-shaped creates strong magnetic field around patient

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magnetic field with radiofrequency alters hydrogen atoms' natural alignment in body

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computers used form 2-dimensional images of structure organ based on activity of hydrogen atoms

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cross-sectional views obtained MRI does not use radiataion like x-rays or CT scan

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MRI process/steps
1*****magnetic field created pulses of radio waves sent from scanner

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2*****radio waves knock nuclei of atoms in body out of normal position

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3******nuclei realign back into position nuclei send out radio signals

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4*****signals received by computer analyzes converts into image of part of body being examined

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5****image appears on viewing monitor

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mammography
x-ray exam of breast detect diagnose breast disease lump pain nipple discharge with or without complaints

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screening mammogram x-ray of breast detects breat changes who have no signs breast cancer 2 x-rays each breast detects tumor that cannot be felt

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diagnostic mammogram x-ray used to diagnose unusual breast changes lump pain nipple thickening discharge change in breast size/shape

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myelogram x-ray exam by radiologist detects abnormalities of spine spinal cord structures radiologist interprets info from procedure reports to doctor

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contrast material seen on x-ray injected into fluid-filled space around spinal cord

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2 contrast materials
oil-based removed after x-ray exam
water-based liquid not removed after x-ray exam

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procedure before/after exam vary depending on contrast material

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aort/o aorta*******
cardi/o heart
cyst/o bladder
hyster/o uterus

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mamm/o breast*********
radi/o radiation
tel/o distance
ven/o vein

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NEW THERAPEUTIC RADIATION THERAPIES
radiation and chemotherapy combo********
radi/chem improve effects of each other

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endovascular brachytherapy*******
interventional procedures like angioplasty/stents used to open blocked areas in blood vessels but close after 3-6 months
radiation at site decreases chance of closure

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intraoperative****** irradiation
exterenal beam radiationtherapy during surgery to treat cancerous tormors/cancers decreased area irradiated tissue target area visible effective dose maybe used

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intraoperative irradiation****** in conjunction with surgery external beam therapy/chemo shown improve outcome of cancer treatment

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stereotactic irradiation*******
new treatment modality to brain cancer treatment single high dose of radiation into diseased tissue very narrow beams of radiation

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2 forms linear acceleration and gamma knife
precision lower amount if invasiveness lower length hospital stay associated costs certain brain cancers/conditions

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particle radiation therapy*******
higher-energy radiation particless cancer therapy benefits to individual cellss under treatment

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2 types particle radiation therapy
fast neutron therapy
charged particle therapy

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fast neutron therapy for inoperablee or recurrent tumors 3 centers in US 10 in the world

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three-dimensional 3D****** conformal radiation therapy
before CT scans 2D
3D defines borders of lesion most precise treatment planning

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thermoradiotherapy******* hyperthermia
elevated temps at sites of treatment improve response certain cancers

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radioimmunmotherapy*******
type of radiation therapy involves using antibodies tagged with radiopharmaceutical substance
antibodies recognize tumor cells binds bringing radiopharmaceutical to tumor tissue tagged antibodies IV artery or skin or body cavity uterus

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advantage of radioimmunotherapy may be used to treat metastases sites away from original lesion/tumor

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not visible by diagnostic means helping eliminate spread of disease

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radioactivity
emissison of radiation when nuclei certain atoms become unstable

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nuclear medicine
specialized area of radiology very small radioactive materials/radiopharmaceuticals examine organ function/structure

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nuclear medicine imaging combo chemistry, physics mathematics, computer tech and medicine
used diagnose treat very early progression disease thyroid cancer

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x-rays pass through tissue intestines muscles blood vessels cnotrast agents used in nuclear imaging examines organ function structure

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diagnostic radiology based on anatomy

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scans used to diagnose many med cond/diseases
brain**** scan investigate problems within brain/blood circ to brain
breast***** scans
with mammograms locate cancerous tissue in breast

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renal scans*****
examine kidneys tumors obstruction of renal blood flow

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thyroid scans*****
thyroid function

gallium***** scans diagnose active infectious/inflammatroy diseases tumors abscesses

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bone scans***** evaluate degenerative/arthritic changes in joints bone diseases tumors cause of bone pain

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heart scans****** abnormal blood flow to heart/extent damage after heart attack measure heart function

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nuclear medicine scans on many organs tissues each type employs technology/radiopharmaceuticals/procedures

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nmc consists 3 phases tracer radiopharmaceutical/administration/taking images/image interpretation

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time betwee administration of tracer and taking images few moments/few days depends on body tisssue and tracer time to obtain images from minutes/hours

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heart scan most commonly performed nm examination myocardial perfusion scans radionuclide angiography scans 2 primary heart scans

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Positron Emission Tomography PET scan
measures metabolic activity cells combo nuclear medicine/biochemical analysis brain/heart/cancer biochemical changes in body metabolism heart muscle

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PET differs detects metabolism in body tissues others NM exams detect amount radioactive substance collected in body tissue

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Intravenous Pyelogram IVP
diagnostic x-ray of kidneys ureters bladder contrast agent urinary tract shows up clearly not seen in x-ray

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IVP to
detect kidney tumors
identify blockages obstructions of normal flow of urine

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detect kidney bladder stoness
prostate gland enlarged
injuries to urinary tract

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Ultrafast CT scan
x-ray beam moves in circle around body different views of same organ/structure more detail

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x-ray of CT sent to computer displays in 2D form on monitor less radiation more images

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ultrafast CT heart disease multiple images time of single heartbeatdecreasing amount of time for study

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ultrafast CT detects small amounts calcium in heart coronary arteries calcium indicates lesions may block off coronary arteries

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cause chest pain heart attack in beginning sstages of formation diagnose early coronary artery disease

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ultrasound ultrasonography
sonography
high-frequency sound waves and computer images blood vessels tissues organs

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view internal organs assess blood flow through vessels abdomen breast female pelvis prostate scrotum thyroid parathyroid vascular system

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evaluate development of fetus

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X-rays
invisible electromagnetic energy beams produce images internal tissues bones organs on film

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diagnosing tumors or bone injuries x-rays pass through soft tissues blood skin fat muscle
bone or tumor denser less rays pass through appears white

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INTERVENTIONAL RADIOLOGY
treatment of patient diagnosis disease treat conditions inside body from outside body inserting small instruments toos catheters wires

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interventional radiologist****** alternative to surgical treatment*****4 years radiology board exam then fellowship

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4000 in US practice in academic medical center larger community hospitals important role on treatment team

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angiography****
x-ray arteries veins detect blockage narrowing of vessels

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angioplasty****
use of small balloon rip of catheter in blood vessel open area of blockage

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embolization*******
substance through catheter in blood vessel stop hemorrhaging excessive bleeding

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gastrostomy tubes
feeding tube inserted into stomach

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intravasular**** ultrasound
ultrasound in blood vessel visualize interior of vessel

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stent *****placement
expandable coil stent in blod vessel visualize interior of vessel

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foreign body extraction
catheter in blood vessel retrieve foreign body in vessel

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needle biopsy
in abnormal area any part guided by imaging techs obtain tissue biopsy no surgery needle breast biopsy

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blood clot filters
small filter in blood clot catch break up clots

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injection of clot-lysing agents******
tissue plasminogen activator TPA injected in body dissolve blood clots increasing flow to heart/brain

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catheters insertions******
in large veins giving chemo drugs nutritional support hemodialysis bone marrow transplantation

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cancer treatment*****
administering cancer meds directly to tumor site

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therapeutic radiology radiation oncology
treatment cancer with radiation**** high energy x-rays kill cancer cells preventing from multiplying**** cure/control/alleviate symptoms cancer

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level of radiation determined by radiation oncologist**** based on type of cancer location sensitivity of surrounding tissue

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PROCESS
simulation set up actual treatment maps out position for patient molds headrests area on body marked be given exact area special sheilds focus radiation protect other tissue

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treatment plan
simulation taken place radiation oncologist determine type of treatment

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COMMON THERAPEUTIC RADIOLOGY PROCEDURES
external beam therapy*****
externally from machine directed to cancer inside patient

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ex. external beam therapy machines
linear accelerators cobalt machines ovrthovoltage x-ray machines

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type of machine determined by oncologist
delivers ionizing radiation to cancer destroying cancer cells

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give healthy cells time to recuperate patients receive small doses radiation time between treatments

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bracchytherapy*******
radiation inside patient close to cancer as possible delivered in body with isotopes chemical elements wires seeds or rods

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brachytherapy
cervical uterine vaginal or rectall cancer eye head and neck cancers and others

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ATOM
smallest unit of matter retain props of element carbon lead helium
NUCLEUS central core electrons orbiting around it nuclei plural

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radioactivity
property certain atoms sponateously emit energy nuclei some atoms unstable eventually adjust more stable form emission of energy

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radiation is energy emitted from radioactive atoms electromagnetic waves or particles

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radioactive matierial radioactive source
refers to any material containing radioactive atoms

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radiation generating device
machine does not typically contain radioactive material or sources generates radioactive fields when operated

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these devices not operating external radiation hazards do not exist
access to radiation hazards during operation restricted through interloks locked doors warning lights removing personnel

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radiation comes from unstable atoms***** trying to rid themselves of excess energy in form of waves or particles

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ionizing radiation*******
enough energy remove electrons from atoms process of ionization

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ex. ionizing radiation include alpha, beta gamma or x-ray and neutron

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non-ionizing radiation
does NOT have sufficient energy***** to remove electrons from atoms within material Ex. non-ionizing visible light infrared light microwaves radio waves

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EFFECTS
exposure to radiation damage to body acute**** or chronic

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acute radiation dose=large amounts ionizing***** radiation received short time effects on body depends on amount received

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below 15,000 no observable effects but may appear over time
above 15,000mrem
observable effects changes to blood count

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over 100,000 mrem diarrhea nausea vomiting

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chronic radiation dose long period time repeatedly small encrements****** EX. chronic radiation=natural background radiation occupational****** radiation

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biological***** effects from chronic radiation occure exposed individual or future children of individual

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slight cancer**** risk small risk compared to natural occurrence of cancer

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developing fetus**** sensitive to ionizing radiation