1. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 1 CHAPTER 23 IMAGING CAREERS

2. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 2 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.

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

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

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

6. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 6 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  Administers dye to make the internal body parts visible  Education 2 years of education is average 2 years of education is average 38 states require certification 38 states require certification

7. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 7 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.  Workers wear a film badge that records the level of exposure to radiologic materials.

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

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

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

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

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

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

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

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

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

17. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 17 Content Instruction  Mammography  Radiograph of the breast to detect cancer Interpreted by a radiologist Interpreted by a radiologist Digital mammography: technique for recording radiograph images in computer code 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  Provides cross-sectional views of the whole body instead of just one region

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

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

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

21. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 21 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.)

22. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 22 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.)

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

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

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

26. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 26 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.

27. Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 27 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.