Introduction to Imaging and Radiologic Sciences

This profession is physical, mental, and emotional, requiring individuals to be scientists, caregivers, patient advocates, and educators.

Medical Radiation Sciences

Medical radiation sciences utilize energy to create images of the human body. Various energy forms can be employed based on the application. Some energy forms create ionizations in human tissue. Energy levels are maintained at safe levels for diagnostic and therapeutic purposes.

Energy modalities used in medical imaging:
- Electromagnetic: X-rays (ionizing). First radiograph was an image of Wilhelm Röntgen’s wife’s hand.
- Radio waves
- Sound: Medical sonography (nonionizing).
- Electrical: Electrocardiography.
- Heat (thermal): Thermography.
- Magnetic: Magnetic resonance imaging (nonionizing).
- Nuclear: Gamma radiation.

Radiography

Uses electromagnetic energy in the form of x-rays to create medical images.
The energy creates ionizations, making the image and harming living tissue.
Competent radiography requires the safe use of electromagnetic energies.

Medical Sonography

Uses high-frequency sound energy to create medical images.
Nonionizing.
Has a wide variety of medical applications.
Credentialing is available through formal education and training.

Magnetic Resonance Imaging (MRI)

Uses the energy of high-strength magnetic fields and radio waves to create images.
Nonionizing imaging modality.

Computed Tomography (CT)

Uses x-ray energy and sophisticated software to create sectional images.
Creates hundreds of views as the X-ray tube and detector rotate around the patient.

Nuclear Medicine

Uses the energy of the atom to create medical images; the energy form is gamma radiation.
Uses radioactive isotopes to create gamma radiation.
Radiopharmaceuticals are administered to patients to assess physiological functioning.
Nuclear medicine technology requires advanced education.

Cardiovascular Interventional Technology

Uses X-rays to visualize human blood vessels and heart anatomy.
Requires a catheter and injection of X-ray contrast material.
Procedures are performed in a sterile angiography lab.
Cardiovascular interventional technologists work closely with angiographers.

Radiation Therapy

Uses very-high-energy ionizing radiation to treat malignant tumors (cancer).
Radiation therapists work with other team members to improve the quality of life of cancer patients.
Involves radiation oncology, medical oncology, and medical dosimetrists to calculate and administer treatment plans.

Career Opportunities

Offers a wide variety of career paths, often beginning with a general radiography background.
Specialty areas require additional education and certification.
Career opportunities are nearly limitless and demand initiative and a desire for professional success.

Specific Career Paths

Radiography, CT Scanning, Medical Sonography, Radiation Therapy, MRI Scanning, Mammography, DEXA Scanning, Radiologist Assistant, Nuclear Medicine, Cardiovascular Interventional Technology, PACS Administrator, Radiology Administration, Education, Research, Commercial Firms (sales, applications, service).

Discovery of X-rays

Discovered by Wilhelm C. Röntgen on November 8, 1895.
Received Nobel Prize in Physics in 1901.
The first known x-ray image was of his wife’s hand.
Barium platinocyanide plate glowed when the tube emitted “rays.”
Roentgen used a Crookes tube for experiments, and his wife’s hand became the first diagnostic x-ray.
Roentgen refused to patent the discovery and died of colon cancer on Feb. 10, 1923.

Terminology

Can be referred to by various names including Radiology, X-ray, Medical imaging, Diagnostic services, and Imaging services. Predominantly a diagnostic service focused on imaging patients to diagnose their medical condition.

Healthcare Team Members

Physicians (Radiologists), Nurses, Allied health personnel, Supporting members and Non-clinical. Hospitals are “communities within communities”. Nursing staff provides direct patient care under the direction of physicians. This includes Nursing Assistants, Licensed Practical Nurses (LPN), Registered Nurses (RN), Nurse Practitioners (LNP), Nurse Midwives, and Nurse Anesthetists (CRNA).

Patient Importance

The patient is the most important member of the health care community.

Patient Care Classifications

Direct, General, Diagnostic, Therapeutic, and Support.

Radiology Department

The Radiology Department is classified as both diagnostic and therapeutic. Most radiologic procedures are diagnostic, but some can be therapeutic.

Information Systems

Health Information Systems (HIS) manage health information. Radiology Information Systems (RIS) manage radiology information, including images and transcriptions.

Preventative Care

Care given while the individual is physically and mentally well (e.g., Pap smear, physical, mammogram, colonoscopy).

Healthcare Setting Changes

Patients are now treated more in outpatient settings and are admitted to the hospital only when very ill or in need of major surgery.

Competition in Healthcare

Patients now have a choice of imaging centers, including OP centers, clinics, emergency care centers, and physician offices. This creates consumer-driven competition, emphasizing the importance of customer service.

Educational Requirements for Radiographers

2-year Certificate Program: No longer accepted.
2-year Associate Program: College-based, requiring basic and general education courses in addition to RT courses.
4-year B.S. Program: University-based, requiring 2 years of basic and general education courses as well as RT courses.

Program Graduates

A graduate from any of these programs can practice as a radiographer and become nationally credentialed.

Education Components

Didactic education, Clinical education, and a Competency-based system:
36 Mandatory, 15 Elective, 10 General Patient Care.

Learning Domains

Cognitive, Psychomotor, and Affective.

Program Structure

Year I: Didactic instruction and learning laboratory. Year II: Clinical instruction.

Question Prompts

What career choice would you like to pursue in imaging sciences, and why?
What are some of the challenges when interacting with various members of the health care team?
What benefits are common to accreditation, certification, and professional organizations?
How would you describe the inter-relationship of the various organizations making up the medical imaging profession?
What factors lead to the most stress in your life?
What steps do you take to manage stress in your life? Which are most effective?
How would you compare your stress management techniques to those of your classmates?

Class Activities

One Sentence Summary Overlay, Guided Notes (Different modalities, X-rays, Healthcare community, Network systems), Skeletal Notes, Peer Review, Take a Break

Quality Assurance Classifications

Accreditation, Certification, Licensure, and Professional Organizations.

Accreditation

A process to ensure high quality of operations and offerings. It is a voluntary peer review process involving several areas within health care. Standards are set by the organization sponsoring the accrediting agency and is highly valued by members of professions.

Types of Accreditation

Programmatic and Regional/Institutional. Programmatic Accreditors include: Joint Review Committee on Education in Radiologic Technology (JRCERT), Joint Review Committee on Education in Diagnostic Medical Sonography (JRCDMS), and Joint Review Committee on Education in Nuclear Medicine Technology (JRCNMT).

JRCERT

Concerned with compliance with education standards developed by and for the profession of radiologic technology. Governed by a Board of Directors known as the Joint Review Committee. JRCERT accreditation requires demonstrated compliance with minimum requirements known as Essentials and Guidelines or Standards.

Established in 1969 (http://www.jrcert.org).
Board members are nominated by four professional organizations concerned with radiology education.
Currently accredits programs in Radiography, Radiation therapy technology, Medical dosimetry, and Magnetic resonance imaging.

Certification

Deals with the demonstration of minimum competencies in recognized professional skills and knowledge. Generally, competency is demonstrated by a test. It is a voluntary process and highly sought after by professionals within health care. A listing of certified individuals is known as a Registry. It is your personal responsibility to achieve and maintain professional certification. Professional certification is a requirement for employment in hospitals.

Certifications Offered

Radiography (R), Nuclear medicine technology (N), Radiation therapy technology (T), General sonography (S), vascular sonography (VS), breast sonography (BS), CT scanning (CT), MRI scanning (MR), Cardiac interventional technology (CI), Vascular interventional technology (VI), Quality management (QM), Bone densitometry (BD), Radiologist assistant (RA), and Mammography (M).

Professional Registry

Certified professionals are listed in a national registry as proof of achievement. Many require ongoing continuing education. Certification provides the privilege of displaying professional credentials as earned.

Certification Organizations

American Registry of Radiologic Technologists (ARRT) (Founded in 1922), American Registry of Diagnostic Medical Sonographers (ARDMS) (Founded in 1975), Nuclear Medicine Technology Certification Board (NMTCB) (Founded in 1977).

Licensure

Some states may require state licensing to practice radiologic technology. Laws can vary greatly from state to state. It is your responsibility to identify which states have licensing. Contact the ASRT for a current listing. Many states will honor certification from a nationally recognized agency such as the ARRT.

Professional Societies

Represent the general welfare of their members by providing Education, Scholarships, Research and special reports, Governmental affairs and appointments, and Malpractice insurance plans.

Professional Organizations

AHRA, ASRT, ASE, AEIRS, AVIR, ISRRT, SDMS, ISMRM, SNM. AMA, AAPM, ABR, ACR, AIUM, ARRS, RSNA, ASTRO, ISCD, SCAR, SNM.

Radiologist and Physicist Organizations
Technologist Organizations

Summary

X-rays were discovered by W.C. Röntgen in 1895. Medical imaging consists of many diagnostic areas involving energy, particularly, radiant energy. Radiologic sciences professionals perform as essential members of a health care team. Career opportunities are nearly limitless and demand initiative and a desire for professional success.

Critical Thinking and Problem Solving Strategies

Discuss experiences as a patient or knowing someone who was a patient and evaluate if situations could have been handled more appropriately. Analyze if the steps taken to analyze situations and develop solutions specific to the clinical environment can also be used in everyday life. Emphasize that teamwork skills are critical to good employment. Review how to employ critical thinking strategies using a teamwork approach.

Radiology Administration

Consider career goals in imaging within the next 10 years, such as remaining a staff technologist, obtaining multiple modality certificates, or advancing to an administrative position. Emphasize preparedness for the responsibility of a higher-ranking position.

Clinical Education

Relate obtaining a driver’s license to learning in the clinical environment. Create additional examples of the SBAR communication method. Describe a situation where poor communication led to inadequate continuity of care, and predict the impact on the patient’s experience and outcome.