1. CHAPTER 23 IMAGING CAREERS
Echocardiography Fluoroscopy
Isotope Polarity
Radiographic contrast media
Radiography Tomography
Ultrasound
Journal question: What personal characteristics might make a student a good candidate for a career in diagnostic imaging?

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. Chapter 23 Learning Objectives
Discuss three important developments in the field of diagnostic imaging.
Identify one imaging technique that does not use radiation.

4. Imaging Careers
Discuss situations in which students or members of their families have used imaging technology for diagnosis or treatment.

5. Imaging Career: Educational Costs and Earnings
Lead a discussion on the cost of training for a radiologist assistant. Ask students to compute total costs to become a radiologist assistant at UAMS. Initiate discussion on salary verses cost of education.

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
38 states require certification
Radiopaque materials may be administered orally, rectally, or intravenously.

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.
The U.S. federal government regulates levels considered to be safe for the radiographers.

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)
Radiology technologists are required to have a college or university degree.
Thirty-eight (38) states certify radiographers.

9. Radiologic Specialties
Nuclear medicine technologist (NMT)
Prepares and administers radioactive compounds
Participates in research activities
Radioactive compounds (radiophamaceuticals) may be injected into the bloodstream, swallowed, or inhaled.
Gamma ray emissions are traced through the body, and the length of time they remain provides important diagnostic information.

10. Diagnostic Nuclear Medicine
Diagnostic nuclear medicine scans are obtained for the
Heart
Brain
Thyroid
Lung
Bone
Echocardiography involves ultrasound studies of the heart and blood vessels.

11. Radiologic Specialties
Ultrasound technologist
Obtains two-dimensional images of internal organs
Specialties
Obstetrics and gynecology
Abdominal ultrasound studies
Neurosonography
The ultrasound technologist is also known as diagnostic medical sonographer.
Sonograms (SOMO) are two-dimensional images.

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 discipline
A 2- to 3-year postgraduate program or clinical medical physics residency program
Certification by the American Board of Radiology
Radiologic physics is concerned with the application of ionizing radiation to medical diagnosis and therapy.

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
The future job market for medical dosimetry is strong. The many advances in treatment planning increases the demand for qualified medical dosimetrists.

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
Specialized training
Cardiac catheterization
Echocardiography
Continuous monitoring
Blood flow studies
Electrocardiogram technicians are not considered imaging personnel, but they may work in the radiology department or area.

15. Medical Imaging Electroencephalographic (EEG) technologists
Measure the electrical activity of the brain to aid in diagnosis of disorders
Place electrode instrument on patient
Monitor patient during testing
Adjust EEG machine
Education
1 to 2 years of training
May seek registration after completing program

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.
Roentgen called the electromagnetic energy X because it was unknown.

17. Content Instruction Mammography Computed tomography (CT)
Radiograph of the breast to detect cancer
Interpreted by a radiologist
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
Mammography is the fastest growing diagnostic procedure.
Fluoroscopy is a type of radiography that shows organs in real time.

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.
The patient is not exposed to much radiation because radioactive materials used have only a short period of activity.

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.
Contrast between different soft tissues is much better with MRI than CT.
MRI also may be referred to as nuclear magnetic resonance imaging (NMRI).

20. Magnetic Resonance Imaging
FIGURE 23-5 A magnetic resonance imaging machine. (Courtesy Siemens Medical Systems, Malvern, Pa.)

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. 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. 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
Digital radiography (DR or DX)
Emerging technique used to reduce time needed for and the expense of processing film
Contrast is better
The amount of exposure to radiation is increased with digital radiography .

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.
Bone density scans are most often used to diagnose and monitor osteoporosis and the risk of developing fractures.

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. 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. 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.

28. Review An echocardiograph is:
a. A record or image of a plane of the body
b. A record or image of a blood vessel
c. A record or image of the heart and blood vessels made with ultrasound
d. A record or image made with sound waves
e. A record or image of the breast

29. Review
An echocardiograph is: a. A record or image of a plane of the body b. A record or image of a blood vessel c. A record or image of the heart and blood vessels made with ultrasound d. A record or image made with sound waves e. A record or image of the breast

30. Review A mammogram is: a. A record or image made using sound waves
b. A record or image of a plane of the body
c. A record or image of a blood vessel
d. A record or image of the breast
e. A record or image of the heart made using ultrasound

31. Review
A mammogram is: a. A record or image made using sound waves b. A record or image of a plane of the body c. A record or image of a blood vessel d. A record or image of the breast e. A record or image of the heart made using ultrasound