50 Diagnostic Imaging

Learning Outcomes 50.1 Explain what X-rays are and how they are used for diagnostic and therapeutic purposes. 50.2 Compare invasive and noninvasive diagnostic procedures. 50.3 Carry out the medical assistant’s role in X-ray and diagnostic radiology testing. 50.4 Discuss common diagnostic imaging procedures.

Learning Outcomes 50.5 Describe different types of radiation therapy and how they are used. 50.6 Explain the risks and safety precautions associated with radiology work. 50.7 Relate the advances in medical imaging to EHR.

Introduction Diagnostic radiology Medical assistant Screening Clinical diagnosis Medical assistant Role during testing Safety issues Proper handling and storage of films Preparation and instruction of patients Learning Outcome: 50.1 Explain what X-rays are and how they are used for diagnostic and therapeutic purposes. Diagnostic radiology is a valuable tool.

Brief History of the X-Ray Discovered in 1895 by Wilhelm Konrad Roentgen X-ray High energy level Short wavelength Learning Outcome: 50.1 Explain what X-rays are and how they are used for diagnostic and therapeutic purposes. X-ray, or roentgen ray, is a type of electromagnetic wave. Travels at the speed of light (186,000 miles per second) Can penetrate solid objects. X-rays react with photographic film to produce a permanent record. The image is lightest where the film is struck by the most X-ray energy. Differences in tissue densities produce the x-ray image Least dense tissue – lightest on film Most dense tissue – darkest on film

Brief History of the X-Ray (cont.) Diagnostic and therapeutic uses Radiologic technologists Radiologist Performs invasive procedures Interprets films Learning Outcome: 50.1 Explain what X-rays are and how they are used for diagnostic and therapeutic purposes. X-rays and radioactive substances have both diagnostic and therapeutic uses. Radiologic technologist: 2- to 4-year curriculum; certified to perform certain radiologic procedures. Radiographers Sonographers Radiation therapists Nuclear medicine technologists Invasive radiologic procedures or procedures requiring a high degree of expertise are nearly always performed by a radiologist. A radiologist is also the physician who interprets the films for other physicians.

Diagnostic Radiology Use of X-ray technology to diagnose Contrast medium Makes internal organs denser Produces a clearer image Types Gases Heavy metal salts Paramagnetic compounds Iodine compounds Learning Outcome: 50.2 Compare invasive and noninvasive diagnostic procedures. Radiologic tests sometimes use contrast media, special techniques or instruments for viewing internal body structures and functions. A contrast medium A substance that makes internal organs denser and blocks the passage of X-rays to the photographic film. Helps to provide a clearer image of organs and tissues, and indications of how well they are functioning. Contrast media Gases – air, carbon dioxide Heavy metal salts – barium sulfate Paramagnetic compounds – substances that are attracted to a magnetic field; used for MRI contrast (gadolinium) Iodine compounds Types of diagnostic imaging include X-rays, computed tomography (CT), nuclear medicine, magnetic resonance imaging (MRI), and ultrasound.

Diagnostic Radiology (cont.) Invasive procedures A testing device is inserted into a blood vessel or organ Requires surgical aseptic technique Patients must be closely monitored Learning Outcome: 50.2 Compare invasive and noninvasive diagnostic procedures. Invasive Procedures Requires a radiologist to insert a catheter, wire, or other testing device into a patient’s blood vessel or organ through the skin or a body orifice. Require surgical aseptic technique. If general anesthesia is used a procedure, an anesthetist will closely monitor the patient during and after the procedure.

Diagnostic Radiology (cont.) Noninvasive procedures View internal structures Uses the conventional x-ray machine or specialized instruments Learning Outcome: 50.2 Compare invasive and noninvasive diagnostic procedures. Noninvasive procedures Use other technologies to view internal structures. They do not require inserting devices, breaking the skin, or the degree of monitoring needed with invasive procedures. The image produced by a conventional may be on a standard x-ray film or captured digitally.

Apply Your Knowledge Right! X-rays are __________________ waves that travel at the speed of light and penetrate solid objects electromagnetic Right! What is the difference in noninvasive and invasive procedures? ANSWER: Noninvasive procedures do not require inserting devices, breaking the skin, or special monitoring and use conventional x-ray machines or specialized instruments to visualize internal organs. Invasive procedures require surgical aseptic technique for the insertion of a catheter, wire, or other testing device into an organ or blood vessel. Learning Outcomes: 50.1 Explain what X-rays are and how they are used for diagnostic and therapeutic purposes. 50.2 Compare invasive and noninvasive diagnostic procedures.

Medical Assistant’s Role in Diagnostic Radiology Assist with or perform procedures Based on scope of practice for state Pre- and postprocedure care Patient education Learning Outcome: 50.3 Carry out the medical assistant’s role in X-ray and diagnostic radiology testing. Your duties in a radiology facility will include assisting a radiologic technologist or a radiologist in performing diagnostic radiologic procedures. Depending on the scope of practice in your state, you may be allowed to learn how to operate certain X-ray equipment. You may provide preprocedure and postprocedure patient care and education. Refer to Educating the Patient: Providing Patient Instruction for Radiologic Procedures

Medical Assistant’s Role in Diagnostic Radiology (cont.) Preprocedure care Schedule appointments Provide preparation instructions Explain the procedure Ask pertinent questions Medication history Women – possibility of pregnancy Learning Outcome: 50.3 Carry out the medical assistant’s role in X-ray and diagnostic radiology testing. Preprocedure Care Explain the procedure to the patient briefly and clearly. Check for clarity and understanding Ask pertinent questions: medication history, pregnant or if there is any chance she could be pregnant. Report the answers to the physician in a medical office or to the radiologic technologist in a radiology facility.

Medical Assistant’s Role in Diagnostic Radiology (cont.) Care during and after a procedure Prepare and assist the patient Assist the radiologic technologist or radiologist Posteroanterior (back to front) Learning Outcome: 50.3 Carry out the medical assistant’s role in X-ray and diagnostic radiology testing. Assist the radiologic technologist or the radiologist in performing the procedure by placing, removing, and developing film in the X-ray machine. Refer to Procedure 50-1 Assisting with an X-Ray Examination

Medical Assistant’s Role in Diagnostic Radiology (cont.) Verifying insurance Prior to testing Obtain necessary referrals Be sure to schedule at a facility contracted with the patient’s health insurance Learning Outcome: 50.3 Carry out the medical assistant’s role in X-ray and diagnostic radiology testing. Verify and complete the necessary referrals for all radiology testing. Make insurance verification a regular step in preprocedure care.

Apply Your Knowledge Very Good! How can you find out what role you can take in radiologic testing as a medical assistant? ANSWER: Check your scope of practice for the state you are working in. Learning Outcome: 50.3 Carry out the medical assistant’s role in X-ray and diagnostic radiology testing. Very Good!

Common Diagnostic Radiologic Tests Common tests Contrast media in diagnostic tests Administered orally, IV, by enema Adverse effects Mild to severe Localized to systemic Check for allergy to iodine or shellfish Monitor patient for signs of allergy Learning Outcome: 50.4 Discuss common diagnostic imaging procedures. Refer to Table 50-1 Common Radiologic Tests and Disorders Diagnosed. Contrast Media in Diagnostic Tests Administered by mouth, by needle or catheter into a blood vessel, or by a route that introduces the medium into an organ or body cavity. Adverse effects in some patients Oral agents – mild and transient abdominal cramping, constipation, nausea, vomiting, diarrhea, skin rashes, itching, heartburn, dizziness, and headache. Intravenous agents – some of the same adverse effects as well as localized injection-site reactions and more serious reactions like anaphylaxis. Many contrast media contain iodine, a common allergen. Ask patients about known allergies to iodine or shellfish, which contain iodine, before procedures involving the use of contrast media. Observe all patients during such procedures for signs of allergic reaction.

Common Diagnostic Radiologic Tests (cont.) Fluoroscopy X-rays cause certain chemicals to emit visible light Allows for viewing movement of an organ or a contrast medium through organs Learning Outcome: 50.4 Discuss common diagnostic imaging procedures. X-rays can cause certain chemicals to fluoresce, or emit visible light. Fluoroscopy Preformed by a radiologist. Allows viewing of internal organ movement or the movement of a contrast medium. Guides the radiologist in locating a precise internal area that needs to be recorded on film or digitally. Fluoroscopic images are sometimes photographed for further study. Photofluorography is a series of these photographs. Cinefluorography is a motion picture of the images.

Common Diagnostic Radiologic Tests (cont.) Hysterosalpingography Examination of uterus and fallopian tubes by fluoroscopy Used to evaluate shape and structure of uterus and patency of fallopian tubes Learning Outcome: 50.4 Discuss common diagnostic imaging procedures. Also called uterosalpingography A radiologic examination of a women’s uterus and fallopian tubes using fluoroscopy. Used to evaluate The shape and structure of the uterus The patency of the fallopian tubes Scarring within the fallopian tubes and peritoneal cavity. Hysterosalpingography is also used to determine presence and severity of Tumor masses Adhesions Uterine fibroids Fallopian tube adhesions Obstructions

Common Diagnostic Radiologic Tests (cont.) Angiography Invasive procedure using a contrast medium Assess arteries or veins Medical assistant Schedule Answer questions Learning Outcome: 50.4 Discuss common diagnostic imaging procedures. Angiography requires a physician to insert a catheter into the patient’s vein (venography) or artery (arteriography). Used to evaluate the heart vessels (coronary angiography), the brain (cerebral angiography), and the femoral, brachial, or carotid artery. A catheter is guided to the vessel to be examined, a contrast medium is injected, and a series of X-rays to assess the vessel’s blood flow and condition are taken. Medical Assistant Schedules the procedure. Encourages the patient to ask questions. Facilities usually have information sheets for each procedure.

Common Diagnostic Radiologic Tests (cont.) Arthrography Contrast medium and fluoroscopy Provides an image during movement Used to diagnose abnormalities or injuries in cartilage, tendons, or ligaments Learning Outcome: 50.4 Discuss common diagnostic imaging procedures. Arthrography Uses a contrast medium and fluoroscopy to help diagnose abnormalities or injuries in the cartilage, tendons, or ligaments of the joints. MRI is used more often to evaluate soft tissue injuries in joints, arthrography can provide an image while the patient moves the joint. Describe the procedure to patients, and inform them the examination will take about 1 hour. Ask patients about possible allergies to contrast media, iodine, or shellfish. No special preprocedure preparations are necessary. Tell the patient to rest and avoid putting strain on the joint for several days following the procedure.

Common Diagnostic Radiologic Tests (cont.) Barium enema Contrast media Single-contrast – barium Double-contrast – barium and air Diagnose and evaluate the colon or rectum. Patient instructions and compliance important Learning Outcome: 50.4 Discuss common diagnostic imaging procedures. Used to diagnose and evaluate obstructions, ulcers, polyps, diverticulosis, tumors, or motility problems of the colon or rectum. Called a lower GI (gastrointestinal) series Two types Single-contrast – only barium is instilled into the colon. Double-contrast – in addition to the barium, air is forced into the colon to distend or inflate the tissue. The air makes structures more visible by fluoroscopy and allows identification of small lesions. Before the Procedure – explain the importance of following the preparation instructions. Bowel must be totally empty. During the Procedure – assist patient and physician as needed. After the Procedure. Barium may cause constipation, the patient should drink extra water. The residual barium may make the stools appear whitish or lighter than usual.

Common Diagnostic Radiologic Tests (cont.) Barium swallow Contrast medium – barium Diagnose and evaluate the esophagus, stomach, duodenum, and small intestine Patient instructions and compliance important Learning Outcome: 50.4 Discuss common diagnostic imaging procedures. Upper GI series – oral administration of a barium sulfate drink Used diagnose and evaluate obstructions, ulcers, polyps, diverticulosis, tumors, or motility problem. Before the Procedure The patient can have nothing by mouth for at least 8 hours before the test. Explain the importance of following the preparation instructions. During the Procedure – assist patient and physician as needed. After the Procedure Another examination may be required after 24 hours to determine whether the barium has moved into the large intestine. Tell the patient to follow a clear liquid diet and to return in 24 hours.

Common Diagnostic Radiologic Tests (cont.) Cholecystography Oral contrast medium Detect gallstones or abnormalities of the gallbladder Cholangiography Contrast medium injected into common bile duct Evaluate function of bile duct Learning Outcome: 50.4 Discuss common diagnostic imaging procedures. Cholecystography Use of a contrast medium to view parts of the gallbladder. Usually used when ultrasound does not provide enough information for a diagnosis. Before the Procedure Explain the diet restrictions necessary to prepare for the test. Instruct the patient to take the oral contrast medium. During and After the Procedure Patient is given a high fat meal A functioning gallbladder empties the contrast medium properly. A nonfunctioning gallbladder may indicate the presence of gallstones or obstruction of the bile ducts. Cholangiography Evaluates the function of the common bile duct. Contrast medium injected directly into common bile duct (during gallbladder surgery) or through a T tube (after gallbladder surgery or during radiologic testing). Medical assistant – Patient instructions Check for allergies

Common Diagnostic Radiologic Tests (cont.) Conventional tomography Uses a computerized camera that moves back and forth over the patient One view per arc over patient Computer tomography Camera rotates completely around the patient Cross-sectional view from each rotation Learning Outcome: 50.4 Discuss common diagnostic imaging procedures. Conventional tomography produces tomograms. Conventional tomography uses a computerized X-ray camera that moves back and forth in an arc over the patient to produce a series of views of a body part. Computed tomography produces CT scans In CT scans produced by computed tomography, the X-ray camera rotates completely around the patient, and the computer compiles one cross-sectional view from each rotation of the camera. Both are used to diagnose abnormalities in almost all body structures. Patient preparation and instructions the same. A contrast medium may or may not be used.

Common Diagnostic Radiologic Tests (cont.) Heart X-ray Angiocardiography Contrast medium used Images of medium flowing through the heart, lungs, and major vessels Coronary arteriography Learning Outcome: 50.4 Discuss common diagnostic imaging procedures. Show the heart’s configuration and to reveal cardiac enlargement and aortic dilation. For angiocardiography, a contrast medium is injected into a major blood vessel. X-rays are taken while the medium flows through the heart, lungs, and major vessels. Coronary arteriography uses a dye inserted through a catheter that has been passed through an artery to the heart. Both procedures require hospital admission, usually in a day surgery or ambulatory surgery unit.

Common Diagnostic Radiologic Tests (cont.) Intravenous pyelography (IVP) Contrast media is injected into a vein Shows contrast medium moving through kidneys, ureters, and bladder Retrograde pyelography – similar to IVP but contrast medium injected through a urethral catheter Learning Outcome: 50.4 Discuss common diagnostic imaging procedures. Intravenous pyelography (IVP) A series of x-rays are taken as a contrast medium travels through the kidneys, ureters, and bladder. Used to evaluate urinary system abnormalities or trauma to the urinary system. Patient instructions regarding preparation – bowel must be clear for visualization. Check for allergies. During and after procedure – assist patient and physician during procedure. Retrograde pyelography Similar to the IVP, except that the doctor injects the contrast medium through a urethral catheter. Used to evaluate function of the ureters, bladder, and urethra, Often used for patients with poor kidney function.

Common Diagnostic Radiologic Tests (cont.) KUB radiography X-ray of abdomen Assesses the size, shape, and position of urinary organs Magnetic resonance imaging (MRI) With or without contrast medium Examines internal structures and soft tissues Learning Outcome: 50.4 Discuss common diagnostic imaging procedures. KUB (Kidneys, Ureters, and Bladder) Radiography – evaluates urinary system diseases or disorders; and to determine the presence of kidney stones. Magnetic Resonance Imaging (MRI) Nonionizing radiation and a strong magnetic field combine to allow the physician to examine internal structures and soft tissues of any body area. High-speed MRI scanners Four times faster than other MRIs making the procedure more tolerable by the patient. Produces clear, high-resolution images.

Common Diagnostic Radiologic Tests (cont.) Mammography X-ray exam of internal breast tissues Specially trained radiologic technologist Mammotest Biopsy Procedure Stereotactic breast biopsy Computer guided Learning Outcome: 50.4 Discuss common diagnostic imaging procedures. Medical assistant – does not assist with testing. Mammotest Biopsy Procedure Stereotactic breast biopsies – less painful and less invasive than conventional excisional biopsies. A computer is used to help determine the exact positioning of the biopsy needle, and the physician takes a small sample of tissue to be examined by a pathologist for the presence of malignant cells.

Common Diagnostic Radiologic Tests (cont.) Myelography Fluoroscopy used to evaluate spinal abnormalities Performed less frequently because of new technology Learning Outcome: 50.4 Discuss common diagnostic imaging procedures. Myelography A kind of fluoroscopy of the spinal cord used when MRI is not practical. Physician performs a lumbar puncture, removes some cerebrospinal fluid (CSF), and instills a contrast medium or air. Used to evaluate spinal abnormalities.

Common Diagnostic Radiologic Tests (cont.) Nuclear medicine Use of radionuclides to evaluate internal organs Types include SPECT PET MUGA scan Learning Outcome: 50.4 Discuss common diagnostic imaging procedures. Nuclear Medicine Involves use of radionuclides, or radioisotopes, administered orally, intravenously, or through routes that introduce them into organs or body cavities. A scanner called a gamma camera. Some images are produced immediately, and others may take up to several days. Exposes patients to lower doses of radiation than some radiologic techniques. SPECT – used to locate and determine the extent of brain damage from a stroke. PET – isotopes combined with other substances involved in metabolic activity are injected. MUGA scan – evaluates the condition of the heart’s myocardium. Provide appropriate patient instructions.

Common Diagnostic Radiologic Tests (cont.) Ultrasound Directs high-frequency sound waves to produce an echo of the internal organ Echoes are converted to an image Learning Outcome: 50.4 Discuss common diagnostic imaging procedures. Ultrasound Directs high-frequency sound waves through the skin over the area of the body being examined and produces an image based on the echoes. The body area is coated with a special gel. A transducer is passed over the area and a computer converts the echoes from the sound waves into an image. Doppler echocardiography – used to determine whether blood flow is laminar (normal) or turbulent (disturbed). Echocardiography – used to study the structure and function of the heart. Instruct patient about the procedure and if any preparation is required.

Bravo! Apply Your Knowledge ANSWER: T F F F T F True or False: ___ Fluoroscopy is used for many procedures. ___ Hysterosalpingography is used to evaluate the patency of the colon. ___ Cholangiography is used to detect abnormalities of the gallbladder. ___ For an IVP, the radiologist injects the contrast medium through a catheter. ___ An MRI uses a combination of nonionizing radiation and a strong magnetic field. ___ Myelography is done frequently to evaluate for spinal abnormalities. ANSWER: T F fallopian tubes F bile duct F Learning Outcome: 50.4 Discuss common diagnostic imaging procedures. a retrograde pyelography T F less often due to advanced technologies

Common Therapeutic Uses of Radiation Radiation therapy – used to treat cancer by preventing cellular reproduction Teletherapy External beam radiotherapy Allows deep penetration of tissues Stereotactic radiosurgery – precise delivery of radiation Learning Outcome: 50.5 Describe different types of radiation therapy and how they are used. Radiation therapy – radiology used therapeutically. Teletherapy External beam radiotherapy. Deep penetration of tissues and is used primarily for deep tumors. The most common form of radiation therapy and is done of an outpatient basis. Stereotactic Radiosurgery Type of teletherapy that uses CT or MRI scanning in conjunction with radiation. Allows for very precise delivery of radiation. Helping spare precious healthy tissue while still treating the tumor.

Common Therapeutic Uses of Radiation Brachytherapy Places temporary radioactive implants close to or directly into the cancerous tissue Requires special precautions for radiation safety Learning Outcome: 50.5 Describe different types of radiation therapy and how they are used. Brachytherapy used to treat localized cancers. Temporary radioactive implants are placed close to or directly into cancerous tissue. This limits radiation exposure to healthy tissue, targeting only the area where the tumor is located. Radiation safety precautions must be closely followed.

Superb! Apply Your Knowledge What are the two types of radiation therapy? ANSWER: Teletherapy allows for deep penetration and is used for deep tumors. Brachytherapy involves the implantation of temporary radioactive implants close to or directly into cancerous tissue. Learning Outcome: 50.5 Describe different types of radiation therapy and how they are used. Superb!

Radiation Safety and Dose Patient exposure reduced Advances in technology Assessment of benefit-to-risk ratio NCRP goals Prevent serious damage from radiation by limiting radiation dose levels Reduce risk of cancer and genetic effects Learning Outcome: 50.6 Explain the risks and safety precautions associated with radiology work. Reducing Patient Exposure Advances in diagnostic imaging technology, and limits to radiation exposure, have helped reduce the dose of radiation to which a patient is exposed during a diagnostic procedure. The physician must assess the benefit-to-risk ratio when recommending a diagnostic radiology procedure. Radiation has a cumulative effect so the physician must have valid medical reasons for ordering the test. The earliest pieces of legislation to limit occupational radiation exposure was enacted in the 1930s. The first legislation to limit public exposure was not enacted until the 1950s. The National Council on Radiation Protection and Measurements (NCRP) – 1993 report set guidelines for protection from radiation in and out of the workplace.

Radiation Safety and Dose (cont.) Personnel safety Wear a radiation exposure badge Make sure equipment is working properly Use lead shields as appropriate Patient safety Learning Outcome: 50.6 Explain the risks and safety precautions associated with radiology work. Understand and follow standard safety precautions in place for protection from radiation exposure. Personnel Safety Always wear a radiation exposure badge, or dosimeter, which is a sensitized piece of film in a holder and have the badge checked regularly. Make sure all equipment is in good working order and is checked routinely for radiation leakage and any other problems. Wear a garment that contains a lead shield. Refer to Educating the Patient: Safety with X-rays

Storing and Filing X-rays Keep fresh film on hand Keep at proper temperature and humidity Prevent pressure marks Keep expiration dates visible Learning Outcome: 50.6 Explain the risks and safety precautions associated with radiology work. Many X-rays are now stored digitally. Guidelines for proper X-ray storage Keep fresh film on hand at all times. Maintain new and exposed films at a temperature between 50º F and 70º F and a relative humidity between 30% and 50%. Prevent pressure marks and keep expiration dates visible by storing packages on end; do not stack them on top of each other.

Storing and Filing X-rays Use oldest film first Open all packages or boxes in darkroom Do not store near acid or ammonia vapors Learning Outcome: 50.6 Explain the risks and safety precautions associated with radiology work. Guidelines for proper X-ray storage (cont.) Use a first-in, first-out method Open film packages or boxes only in the darkroom. Do not store film near acid or ammonia vapors. Refer to Procedure 50-2 Documentation and Filing Techniques for X-rays X-ray films are the property of the radiology facility or the doctor’s office.

Great! Apply Your Knowledge What should the physician consider before ordering radiologic testing for a patient? ANSWER: The benefit-to-risk ratio. How do you store new and exposed x-ray film? Learning Outcome: 50.6 Explain the risks and safety precautions associated with radiology work. ANSWER: X-ray film should be stored at proper temperature and humidity. Packages should be stored on end and not stacked. Great!

Electronic Medicine Telemedicine technology Rapid video Computer-based communications Uses include Viewing medical images Consults Transmission of data electronically Learning Outcome: 50.7 Relate the advances in medical imaging to EHR. Telemedicine technology – uses: “Examining” a patient in another city or country. Viewing highly detailed medical images. Consulting with specialists in other cities. Supervising complex medical procedures. Interactive teaching conferences by means of closed-circuit television. Transmitting an ECG electronically to an emergency room physician to obtain life- saving directives from the physician. Monitoring patients by the transmission of daily ECGs through telephone lines.

Electronic Medicine Digital imaging and EHR Digital reader “captures” image Advantages include Better image quality Faster results Decreased radiation exposure Learning Outcome: 50.7 Relate the advances in medical imaging to EHR. Digital Imaging and the EHR Radiology is completely technology driven as a specialty. Digital radiology (DR) devices that are integrated with the EHR system Provide quality images Provide rapid access Eliminate the time and equipment associated with film processing and development. A digital reader “captures” or digitizes the X-ray image instead of exposing traditional film. Other advantages Better image consistency and quality Easier X-ray file sharing Simpler storage Environmentally safer (producing the image requires no chemicals)

Electronic Medicine DICOM Advances in radiology – 3D/4D ultrasound Standard for handling, storing, and transmitting information in medical imaging PAC ~ digital storage area Advances in radiology – 3D/4D ultrasound Learning Outcome: 50.7 Describe advances in medical imaging and the relation to the EHR. DICOM – Digital Imaging and Communications in Medicine A communications protocol or standard for handling, storing, printing and transmitting information in medical imaging. Designed as part of the Integrating the Healthcare Enterprise (IHE) initiative. A Picture Archive and Communication System (PAC) – the digital storage area where digital images are sent and stored for diagnostic viewing and electronic image storage and distribution. 3D/4D ultrasound Observe fetal movement Study body organs Guide needle biopsies

Apply Your Knowledge Fantastic! What is DICOM? ANSWER: DICOM is a communications protocol for handling, storing, printing, and transmitting information in medical imaging. Learning Outcome: 50.7 Relate the advances in medical imaging to EHR. Fantastic!

In Summary 50.1 An X-ray is a high-energy electromagnetic wave that travels at the speed of light and can penetrate solid objects. X-rays can be used for diagnosis by producing images of internal body structures. Therapeutically, X-rays are used to treat cancer by preventing cellular reproduction.

In Summary 50.2 Invasive procedures require a radiologist to insert a catheter, wire, or other testing device into a patient’s blood vessel or organ through the skin or a body orifice. Noninvasive diagnostic procedures do not require inserting devices, breaking the skin, or the degree of monitoring needed with invasive procedures.

In Summary (cont.) 50.3 A medical assistant can work directly with a radiology facility to assist the radiologist or technicians in performing diagnostic procedures. Providing preprocedure and postprocedure care are duties a medical assistant can perform in a medical or radiology facility.

In Summary (cont.) 50.4 Numerous diagnostic imaging procedures are used in medicine today including: angiography, fluoroscopy, MRI, CT, arthrography, IVP, KUB, mammography, upper and lower GI series, ultrasound, and cholangiography.

In Summary (cont.) 50.5 The two basic types of radiation therapy are teletherapy and brachytherapy. Teletherapy is also called external beam radiotherapy because an external beam of radiation is used to penetrate deep tumors. Brachytherapy uses temporary radioactive implants positioned close to or directly into cancerous tissue to treat the tumor and spare healthy tissue.

In Summary (cont.) 50.6 The greatest risk associated with a radiology facility is the potential for radiation exposure to patients and healthcare workers. To eliminate this risk, certain safety precautions should be followed. These include careful evaluation by the physician to determine the medical necessity of radiology testing, avoiding X-rays altogether if a patient is pregnant, and requiring all personnel who work in a radiology facility to wear a dosimeter.

In Summary (cont.) 50.7 Major advances in telemedicine technology, including rapid video and computer-based communications of medical information, enable physicians to “examine” a patient in another city or country, view highly detailed medical images, consult with specialists in other cities, and supervise complex medical procedures. Sharing records including actual radiographic images between facilities is easier with the advent of digital radiographic procedures and the electronic health record.

End of Chapter 50 Words can be like X-rays if you use them properly--they'll go through anything. You read and you're pierced.” ~ Aldous Huxley