Radiology Information Resource for Patients

Intravenous Pyelogram

An Intravenous Pyelogram (IVP) is a radiological procedure used to visualize the urinary system. This includes the kidneys, ureters and bladder. A injection of x-ray contrast media is given to the patient through the vein. It then becomes visible on a x-ray almost immediately after injection. X-rays are taken at specific times to capture the contrast as it travels through the parts of the urinary system. The images will give a review of the patients anatomy and information on the functioning of the renal system.

Nuclear Medicine

Nuclear medicine uses radioactive isotopes and relies on radioactive decay in the diagnosis and treatment of disease. The patient is injected with radiopharmaceuticals that can localize specific organs or cellular receptors. This allows nuclear medicine to have the ability to image the extent of a disease-process in the body. In some cases nuclear medicine studies can identify medical problems at an earlier stage than other diagnostic tests. External detectors (gamma cameras) capture and form images from the radiation emitted by the radiopharmaceuticals. There are several techniques used in nuclear medicine. Scintigraphy uses radioisotopes to create 2-D images, SPECT is used to create 3-D projections and Positron emission tomography (PET) uses detection to image functional processes. The amount of radiation from diagnostic nuclear medicine procedures is kept "ALARA" As Low As Reasonably Achievable). The dose can vary greatly depending on the type of study. Some procedures requie patient preparation before the study. For example, dietary preparation or withholding certain medicaitons. The medication used in nuclear medicine emits ionizing radiation that travels short distances and minimizes unwanted side effects and damange to uninvolved organs. Most procedures are outpatient procedures, meaning the patient will go home the same day. Some of the most common procedures are 131l-sodium iodide for hyperthyroidism and thyroid cancer, yttrium-90 and iodine-131 for refractory lymphoma and 131I-MIBG for neuroendocrine tumors.

Radiation Therapy

Radiation Therapy is the medical use of ionizing radiation as part of treating cancer and to control malignant cells. Radiation therapy is also known as Radiotherapy. The use of radiation therapy on non-mailignant conditions is limited partly by worries about the risk of radiation-induced cancers. With treating cancer, radiation therapy also can be combined with surgery, chemotherapy, hormone therapy or a mixture. To spare normal tissues (skin or organs radiation must pass through to treat the tumor), the radiation beams are shaped and aimed from several angles to intersect the tumor and to provide a larger absorbed dose then in the surrounding, healthy tissue. Radiation therapy works by damaging the DNA of cells by free radicals and since cancer cells are stem-like they reproduce more and have a diminished ability to repair sub-lethal damage compared to healthy cells. The DNA damage is inherited through division and accumulates damage to the cancer cells causing them to die or reproduce more slowly. There are three types of radiation therapy. External beam radiotherapy, brachytherapy and unsealed source radiotherapy. The differences relate to the position of the radiation souce. External is outside the body, brachytherapy uses radioactive sources placed in the area under treatment and unsealed source radiotherapy is given by infustion or orally.

CT / MRI

CT, otherwise known as Computed tomography is a medical imaging method created by computer processing. It is used to create a 3D image of the inside of an object. Usage of CT has increased dramatically over the last number of years with an estimated 72 million scans performed in the United States. The CT is used to take images of the head, chest, heart, abdomen and extremities. An advantage to CT is that it almost completely eliminates the superimposition of images, distinguishes the difference between tissues that differ in physical density by less than 1% and finally, images can be viewed in the axial, coronal or sagital plane from one procedure. A disadvantage is the CT produces a moderate to high radiation technique and gives out more radiation then the normal radiograph. So, unless medically necessary, a CT usually isn't ordered by the Dr. unless it absolutely needs to be done.

MRI or magnetic resonance imaging is used to visualize detailed internal structures limited to the function of the body. A MRI provides a greater contrast between the different soft tissues of the body than a CT. A MRI makes neurological, musculoskeletal, cardiovasuclar and oncological imaging very useful. A positive thing about MRI is that it uses no ionizing radiation, but uses a powerful magnetic field to align hydrogen atoms in the water in the body.

Both MRI and CT scans are performed similarly. Depending on the body part being imaged the patient might or might not have to change into a gown. Once changed, they are laid down on a table that slides through a large doughnut or tube. The patient is advised to hold very still during the procedure to avoid blurring of images. The patient will follow any of the techs advise, for example, take a deep breath or hold still. The average exam can take from 15 to 60 minutes. Once complete, the patient will change into their street clothes and their doctor will contact them about any information found.

Radiographs (aka X-rays)

Radiographs (X-rays) use ionizing electromagnetic radiation to view objects. Radiographs are the most common tool used in the diagnostic imaging department, and they are the second most commonly used medical test after laboratory tests. I'm sure everyone reading this blog has had a radiograph taken before. X-rays may seem harmless since you can't feel, see, hear or smell them. But most people don't realize they actually can be harmful. It is vital if you are planning on having a radiograph taken that important safety precautions are used. Radiology technologists are trained to protect people and their environment from the harmful effects of ionizing radiation. Radiation can cause microscopic damage to living tissue, resulting in burns and radiation sickness and can even cause cancer, tumors and genetic damage. It is very important that if you think you might be or you are pregnant to avoid any type of radiologic procedure. Be sure that your radiology technologist covers you with some type of lead shielding (unless it covers vital parts that need to be seen in the radiograph). The radiology technologist also needs to make sure the time of the exposure is accurate and that distance is put into place. Once your doctor orders a radiograph you are typically taken into a dressing room and given a gown to change into. You must remove all jewelry or metal objects that might show up in the radiograph. You will then be guided to the procedure room. The x-ray machine can seem a little intimidating because its so large and the table you lay on is cold and hard. Your radiology technologist should try to make the procedure as comfortable as possible. They will then position you to where they want to take the radiograph and it is vital to follow all their directions. For example, if they advise you to take in a deep breath,hold it, and don't move. You must follow the steps to avoid a retake of the image. You don't want to have to do a retake because you have just doubled your dose of radiation. Last, they should always try to put some type of lead shielding on you before they take an exposure, unless they aren't able to. The technologist will set the technical settings, take the image, and check over them to make sure they are acceptable. Then they will advise you to go back to the changing room and you can change into your street clothes. It's a pretty fast and simple procedure. Posted are a few examples of what a radiograph might look like.

What's a Radiologic Technologist?

A Radioloigic Technologist or Radiographer is a medial professional who applies doses of ionizing radiation to patients to create medical images of the human anatomy. The images aid Radiologists and Physicians in treating and diagnosing illness and injury. They work in hospitals, clinics, laboratories, nursing homes and in a private practice. The Radiologic Technologist is responsible for setting the amount of radiation that will be given to the patient using the ALARA technique (As Low As Reasonably Achievable). They are to provide excellent patient care to ensure patient safety, comfort and satisfaction. They are also required to provide as much protection to the patient from radiation as possible. This is done by giving the patient lead shielding, accurate collimation of the x-ray machine, and having to avoid any retakes of any examinations. You should always expect adequate hand washing techniques from them before and after each individuals exam, rooms and equipment to be clean and adequately prepared for the procedures, and you should always feel like you have the right to ask any questions or advise any concerns you might have. A Radiologic Technologist is not a Physician, so they are not educated in diagnosing any medical images for the patient. The patient should always advise their Physician if they have any questions regarding their images. The number one goal for the Radiologic Technologist is always patient care!

Purpose

Imagine going into your Dr's office and he tells you that you will have to have an "Intravenous Cholangiography". You think to yourself "What is that? Is it serious? Will it hurt?". Hundreds of questions enter your mind as the Dr. exits the room with not enough time on his hands to answer but maybe two of your one hundred questions. I know many people have been in this situation and it can be discouraging. Working in the health care field and being in the RT program, I understand a lot of the medical terminology lingo. But I always have to remind myself that maybe our patients don't, and that they may have several questions and concerns that need to be addressed before they agree to the procedure. That is why I have started this blog. I want to educate people about the different types of radiological procedures and the RT's function as a health care provider. I want people to feel confident going into a procedure and feel like they have made the right decision. I plan on doing posts on the different types of radiological procedures and what you can expect. Please let me know if you are planning on having a procedure done, and I would love to do a post about it. Thanks!