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RAD TECH A WEEK 2 CAREER’S IN RADIOLOGY 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 Events Crookes tube Air evacuated glass tube Cathode side Anode side Electrical supply Screen or board painted with barium platinocyanide Low light work area X-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 this in 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 Radiologic Technologist do? Radiologic Technologist Help others Work with people Make a difference Think critically Demonstrate creativity Achieve results Radiologic Technologist •Must be able to COMMUNICATE EFFECTIVELY with •PATIENTS, STAFF & PEERS •Must use GOOD JUDGEMENT & CRITICAL THINKING SKILLS FIG. 4–2 Radiologic science professionals must use advanced critical thinking skills when handling all patient care situations. Elsevier items and derived items © 2007, 2003 by Saunders, an imprint of Elsevier Inc. 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. NATIONAL LICENSURE ARRT arrt.org • 275,000 Registered RT (R) • 2007: 15,285 exams – 89% Radiography – 3.6 % Nuclear Med – 7.1 Radiation Therapy 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 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) FLUOROSCOPYXRAYS IN MOTION Fluoroscopy Gastrointestinal Exams ARRT Exams Primary 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 Radiography Advanced Modalities POST – PRIMARY EXAMS (TAKEN AFTER COMPLETIONS OF ARRT – RT License) (M) Mammography (CT) Computed Tomography (MRI) Magnetic Resonance Imaging (QM) Quality Management (US) Sonography Vascular Sonography Breast Sonography (BD) Bone Densitometry (CV) Cardiac-Interventional Radiography (CIV) Vascular-Interventional Radiography Advanced Practice (R.R.A) Registered Radiologist Assistant Imaging Informatics Certification Program Merging IT and Medical technology PET MANAGEMENT (BS or BA) EDUCATION (BS,MEd, PhD EDD) 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 HEALTH CARE TEAM MEDICAL CENTER RADIOLOGY RADIOLOGIST TECHNOLOGIST VS TECHNICIAN RADIATION RADIATION ENERGY IONIZATION- adding or removing an electron IONIZING RADIATION NON-IONIZING RADIATION 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 CT SCANNER • USES • Ionizing RADIATION – AND A COMPUTER • TO RECONSTRUCT • IMAGES • 3-D 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.) 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 after injections 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 TECHNOLOGY is 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. ULTRASOUND Cypress College Orange Coast LLU 1 – 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?