RAD TECH A WEEK 2

CAREER’S IN CAREER’S IN RADIOLOGYRADIOLOGY

RADIOGRAPHIC EQUIPMENT

Spring 2009

HISTORY REVIEW

• WHO

• WHAT

• WHEN

• The discovery of X rays by the German physicist Wilhelm Roentgen in 1895 was an international sensation.

• Working with vacuum tubes, he bombarded a metal plate with high speed electrons.

• He found that invisible rays were produced. These mysterious new rays could go through skin and flesh and give a picture of a person's bones.

Collaborative EventsCollaborative Events

Crookes tubeCrookes tube Air evacuated glass tubeAir evacuated glass tube Cathode sideCathode side Anode sideAnode side Electrical supplyElectrical supply

Screen or board painted with barium Screen or board painted with barium platinocyanideplatinocyanide

Low light work areaLow light work area

X-rays – the Basic Radiological ToolX-rays – the Basic Radiological Tool

Roentgen’s experimental apparatus (Crookes tube) that led to the discovery of the new radiation on 8 Nov. 1895 – he demonstrated that the radiation was not due to charged particles, but due to an as yet unknown source, hence “x” radiation or “x-rays”

Known as “the radiograph of Bertha Roentgen’s hand” taken 22 Dec. 1895

Hand images Today !

“Willie Roentgen”

• Honored in 1901 with the first Nobel prize in physics for his efforts.

X-ray production begins at the atomic level

Energy (photons) are released when the electron collides with another electron,

the change in e of the shells –produces photons

More on thisin week 4 !

CAREERS IN RADIOLOGIC TECHNOLOGY

• RADIOLOGIC TECHNOLOGIST– RADIOGRAPHER– X-RAY

TECHNOLOGIST

• TECHNICIAN

• RADIOLOGIST

Objectives

• Define the Radiology Team

• Illustrate Careers in and around Radiology

• Identify work environments for Imaging Technologists

What does a What does a Radiologic Radiologic Technologist do?Technologist do?

Radiologic Radiologic TechnologistTechnologist Help othersHelp others Work with peopleWork with people Make a differenceMake a difference Think criticallyThink critically Demonstrate creativity Demonstrate creativity Achieve resultsAchieve results

FIG. 4–2FIG. 4–2 Radiologic science professionals must use advanced critical thinking skills when handling all patient care Radiologic science professionals must use advanced critical thinking skills when handling all patient care situations.situations.

Elsevier items and derived items © 2007, 2003 by Saunders, an imprint of Elsevier Inc. Elsevier items and derived items © 2007, 2003 by Saunders, an imprint of Elsevier Inc.

Radiologic Technologist

•Must be able to COMMUNICATE EFFECTIVELY with

•PATIENTS, STAFF & PEERS

•Must use GOOD JUDGEMENT & CRITICAL THINKING SKILLS

Practices

RADIATION

SAFETY

TO SELF

& OTHERS

Early years in Radiologic Technology

• Nurses or nurses aides taught how to “take an x-ray”

• NO special education• Only “ON THE JOB” training• Experience the best teacher

• The first Technologist is credited to be EDWARD C. JERMAN.

ARRTarrt.org

• 275,000 Registered RT (R)

• 2007: 15,285 exams – 89% Radiography– 3.6 % Nuclear Med– 7.1 Radiation Therapy

NATIONAL LICENSURE

Consumer Assurance of Radiologic Excellence

The (CARE) bill  

• would ensure that patients undergoing all types of radiologic procedures

• have the same assurance of quality as those receiving mammograms

• under the provisions of the Mammography Quality Standards Act.

CARE BILL

• Consistency, Accuracy, Responsibility, and Excellence...ARRT Among Supporters Seeking To Ensure Patient Safety Through Adoption of CARE Bill

• ASRT – American Society of Radiologic Technologist ASRT.org

As of Sept 2001- 16 states have no licensure lawsAs of Sept 2001- 16 states have no licensure laws

Diagnostic Radiologic Technologist

Aka: Radiographer

Not a “Technician”

Types of Diagnostic Exams

• CHEST

• EXTREMITIES

• SKULL / FACIAL

• SPINE

• GASTROINTESTINAL

Trauma

Mobile

“TRAUMA”

ALL PATIENTS

ELDERLY

INFANTS & CHILDREN

UNIQUE, UNUSAL, INTERESTING, ETC

SURGERY

TECHNOLOGIST

• FLUOROSCOPY

• CONTRAST MEDIA (X-RAY DYE)

• KELLY HOLT, ARRT R.T. (R)

FLUOROSCOPY- XRAYS IN MOTION

Fluoroscopy Gastrointestinal Exams

ARRT ExamsPrimary Examinations

• Five “Primary Exams”

offered by the ARRT

5 Primary Exams

•  Radiography (R)• Nuclear Medicine Technology (NM)• Radiation Therapy (T)• Sonography (US) (RDMS)• Magnetic Resonance Imaging (MR)

• candidates must have successfully completed a formal educational program in the respective discipline that is accredited by a mechanism

acceptable to ARRT.

Beyond Diagnostic Beyond Diagnostic RadiographyRadiography

Advanced ModalitiesAdvanced Modalities

POST – PRIMARY EXAMSPOST – PRIMARY EXAMS(TAKEN AFTER COMPLETIONS OF ARRT – RT License)(TAKEN AFTER COMPLETIONS OF ARRT – RT License)

(M) Mammography(M) Mammography (CT) Computed Tomography(CT) Computed Tomography (MRI) Magnetic Resonance Imaging(MRI) Magnetic Resonance Imaging (QM) Quality Management(QM) Quality Management (US) Sonography(US) Sonography

Vascular Sonography Vascular Sonography Breast Sonography Breast Sonography (BD) Bone Densitometry(BD) Bone Densitometry (CV) Cardiac-Interventional Radiography(CV) Cardiac-Interventional Radiography (CIV) Vascular-Interventional Radiography(CIV) Vascular-Interventional Radiography

Advanced PracticeAdvanced Practice (R.R.A) Registered Radiologist Assistant(R.R.A) Registered Radiologist Assistant Imaging Informatics Certification ProgramImaging Informatics Certification Program

Merging IT and Medical technology Merging IT and Medical technology

PET PET MANAGEMENT (BS or BA)MANAGEMENT (BS or BA) EDUCATION (BS,MEd, PhD EDD)EDUCATION (BS,MEd, PhD EDD)

Another way to categorize Another way to categorize medical imaging medical imaging

IonizingIonizing DiagnosticDiagnostic FluoroscopyFluoroscopy Special Procedures:Special Procedures: InterventionalInterventional AngiographyAngiography Cardiac CathCardiac Cath CTCT MammographyMammography Bone DensitometryBone Densitometry Nuclear MedicineNuclear Medicine Radiation TherapyRadiation Therapy

Non IonizingNon Ionizing

UltrasoundUltrasound SonographySonography

MRIMRI

HEALTH CARE TEAMHEALTH CARE TEAM MEDICAL CENTERMEDICAL CENTER

RADIOLOGYRADIOLOGY

RADIOLOGISTRADIOLOGIST

TECHNOLOGIST VS TECHNOLOGIST VS TECHNICIANTECHNICIAN

RADIATIONRADIATION

RADIATIONRADIATION

ENERGYENERGY IONIZATION- IONIZATION-

adding or removing adding or removing an electronan electron

IONIZING IONIZING RADIATIONRADIATION

NON-IONIZING NON-IONIZING RADIATIONRADIATION

What is Ionization?

When an electron is added or removed from the atom- it is

ionized

Another way to categorize medical imaging

Ionizing• Diagnostic• Fluoroscopy• Special Procedures:• Interventional• Angiography• Cardiac Cath• CT• Mammography• Bone Densitometry• Nuclear Medicine• Radiation Therapy

Non Ionizing

• Ultrasound Sonography

• MRI

MAMMOGRAPHY

Colleen McFaul, RT (R) (M)

RADIOGRAPHIC IMAGING OF THE

BREAST Dx for breast cancer

Mammography

• RT (R) (M)

• 1992 began post primary exam for mammographers

• Uses Ionizing

Radiation

Bone Densitometry

“low dose

Ionizing Radiation”

BONE DENSITOMETRY

• JOE RUIZ, RT (R) (BD)

• POST PRIMARY EXAM BEGAN IN JANUARY 2001

• May also have certification w/o RT

• MEASURING MINERAL CONTENT AND DENSITY OF BONES

Bone densitometry

                                                    

CT SCAN & MRI

Computed Tomography

• Kelly Clark, RT (R) (CT)

• 1995 began post primary exam

FIG. 1–9 A computed tomographic technologist uses a computerized x-ray system to produce sectional anatomic images of the body.

(Courtesy of Philips Medical Systems.)

CT SCANNER

• USES• Ionizing RADIATION

– AND A COMPUTER

• TO RECONSTRUCT

• IMAGES

• 3-D

Magnetic Resonance Imaging

• RT (R) (MRI) or

• RT (MRI)

• 1995 ARRT began post primary exams

MRI SIGNAL PRODUCTION

• Images are crated by interaction of Magnet field, radio waves with tissue

• Atoms – Nucleus – Electrons

• Non Ionizing Radiation

MRI EXAMS

• MRI is growing as an alternative to traditional x-ray mammography.

RADIOGRAPHY VS MRI

BONE vs Soft Tissue

NUCLEAR

MEDICINE

use radioactive isotopes to make images

Nuclear Medicine

• RT (NM)

• ARRT or NMTCB

scans use radioactive

isotopes to make images

NM – Images collected afterinjections of a RADIOISOTOPE

PET Scan & SPECT Scan

• PET = Positron Emission Tomography

• Single Photon Emission Computed Tomography

• CT (x-rays) or MRI with Radioisotopes

ANGIOGRAPHY/ CARDIOVASCULAR INTERVENTIONAL

TECHNOLOGYis a specialized radiographic examination where the images of the blood vessels of the body are demonstrated by injection of contrast media.

Cardiovascular Interventional Radiography

• Jane Smith, RT (R) (CVI)

• Angiography

• RT (CV) (CIT) (CVIT)

• 1991 began post primary exam for CVIT Radiographers

INTERVENTIONAL RADIOGRAPHY

• Uses

• Fluoroscopy

• Ionizing

Radiation

ANGIOGRAPHY is a specialized radiographic examination where the images of the blood

vessels of the body are demonstrated by injection

of contrast media

RADIATION THERAPY

R.T.(T)• 1 - 4 YRS ADDITIONAL EDUCATION

• CITY OF HOPE

• LLU

• CAL STATE LONG BEACH

• The branch of Radiology that involves the treatment of disease by means of high energy x-rays or radioactive substances

Radiation Therapy

• RT (T) = Registered technologist in radiation therapy technology

• Medical dosemetrists are involved in treatment planning and dose calculations

• 1-4 year program

                                     

ULTRASOUND

uses a technique similar to Navy SONAR to produce diagnostic images.

ULTRASOUNDCypress CollegeOrange Coast

LLU1 – 2 years

FIG. 1–10 A diagnostic medical sonographer uses high-frequency sound waves to create images.

(Courtesy of Philips Medical Systems.)

Diagnostic Medical Sonographers

• RT (R) (S) or RT (S) or (RDMS)

• American Registry of Diagnostic Medical Sonographers

• ARRT in 1999 began post primary exam

• ARRT in 2005 began primary exam

Uses SOUND WAVES (NOT X-RAYS)

“real time” images

U/S & the “real thing”

Breast Sonography

• Post Primary Exam

• Valuable for Technologists that specialize in Mammography

VASCULAR ULTRASOUND

Additional Opportunities

• Education

• Administration

• Management (QM)

• Commercial

• Radiologist Assistant = RRA

New - RRA• Radiology Assistant (Like PA)

• Weber State (On line – Utah)

• LLU

• 3 others in US (2007 – more)

• $$$$ NEW GRADS = 100 K/YEAR (?)

• PART OF RADIOLOGIST GROUP

• As of 2007 – NOT APPROVED BY STATE to Work as RA in California

RADIOLOGY ASSISTANT RA

• LLU • 2 YRS RT• BA DEGREE

• WEBER STATE• 6YR RT

OTHER PATHWAYS

• SALES

• APPLICATIONS SPECIALIST

• INDUSTRIAL X-RAY

• MANAGEMENT (DEGREE)

• EDUCATON

Work Opportunities

• Hospital

• Imaging Center

• Doctor’s Office

• Mobile Trailer

• Research

Variety of Work Settings• physicians offices,• clinical outpatient facilities, • free standing imaging centers, • mobile imaging centers • portable services to rehabs • Mammo’s to under privileged

areas• Urgent care

Other working opportunities…

• Registry (local)

• Registry (out of state)

• X rays taken around the world !!

TRAVELING TECHNOLOGIST = SEE THE WORLD AND GET $$$

NEED – JOB SECURTIY

• PEOPLE ARE GETTING OLDER – LIVING LONGER

• TECHNOLOGIST ALSO GETTING OLDER

• NEED NEW, YOUNG PEOPLE TO TAKE OVER THE JOBS & TAKE CARE OF THE SICK AND ELDERLY

REVIEW: PRIMARY EXAMINATIONS ?

• RADIOGRAPHY

• NUCLEAR MEDICINE TECHNOLOGY

• RADIATION THERAPY

• SONOGRAPHY (7/05)

• MAGNETIC RESONANCE (2006)

Review

• Radiology Team

• Patient Care Careers

• Other Careers Opportunities

• Work Settings

HISTORY REVIEW

• WHO

• WHAT

• SERIES OF EVENTS

• WHEN

QUESTIONS?