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MEDICAL IMAGING RADIOLOGY • Radiology is a medical specialty that uses imaging techniques to both diagnose and treat disease visualized within the human body. • Imaging technologies include x-rays, ultrasound, computed tomography, nuclear medicine, positron emission tomography and magnetic resonance imaging, all of which are used to diagnose or treat diseases. Ultrasounds • Uses high-frequency sound waves to image organs and body structures • Can look at heart, blood vessles, kidneys, liver and other organs as well as soft tissues • Sounds waves are reflected (echo) off of different density tissues differently Ultrasound cont’d • A transducer sends out sound waves, which bounce off at different speeds depending on the density of the tissue or organ • The transducer also receives the sound waves that are bounced back Why ultrasound? • Condition of a fetus • Check thyroid gland • Diagnose some forms of cancer (e.g. breast, prostate, GI tract) • Evaluate abnormalities of muscles and tendons • Cardiac problems • Abnormalities in reproductive organs Risks? • No documented risks; no ionizing radiation • higher power sound waves are used (for treatment); they could can heat and destroy tissue X-Rays • Based on the fact that larger atoms (as in bone-Calcium) absorb X-rays than smaller ones (as in soft tissues) • X-ray machine generates X-ray photons which are funnelled into a narrow beam X-rays cont’d • Camera on the other side of patient records patterns of X-ray absorption • Hard materials like bone appear white and softer materials appear black or gray • Contrast media is used if soft tissues are of interest – e.g Barium – absorbs X-rays better • Can even trace the path of a contrast media through the body using fluoroscopy • Can also be used to see soft tissues with the help of stains (ex. barium) Risks? • Considered safe and benefits of early detection are thought to outweigh risks of x-ray exposure • It is possible that there is cell damage – most would die • If you had 300 medical x-rays a year, increase in cancer risk by 1 percent (USDA) • Caution for pregnant women – no CT scans • Question of cummulative exposure? CAT Scans: computerized axial tomography scan • An X-ray machine rotates around the patient taking hundreds of individual pictures form many angles • More sensitive than an X-ray alone • Computer re-assembles the picture into a 3-D image, allowing for organs to be viewed section-by-section A CT or CAT scan (computed tomography) is a much more sensitive imaging technique than x-ray, allowing high definition not only of the bony structures, but of the soft tissues. Clear images of organs such as the brain, muscles, joint structures, veins and arteries, as well as anomalies like tumors and hemorrhages may be obtained with or without the injection of contrasting dye. Radiation exposure comparison Type Radiation reading (mSV) Single fatal dose, fatal within weeks 10,000 Accumulated dosage that could cause Fatal cancer in 5 % of people 1,000 Recommended limit for radiation workers Every 5 years 100 CT scan: heart 16 CT scan: abdomen & pelvis 15 Dose in full-body CT scan 10 Mammogram 0.40 Chest x-ray 0.10 Dental x-ray 0.01 Daily background dose in Ottawa 0.00040 Yearly background dose in Ottawa 0.146 MRI • Magnetic Resonance Imaging An imaging technology that uses magnetism, radio waves adn a computer to produce images of body structures. The MRI scanner is a tube surrounded by a giant circular magent. • The magnet creates a strong magnetic filed that aligns the protons of hydrogen atoms. • The protons are then exposed to radio waves, which make them spin. This spinning produces a signal from which an image is produced. What is MRI good for? • Accurate disease detection throughout the body e.g. tumours of the brain, inflammation of the spine, structure of the heart CT vs. MRI Depends on what is being diagnosed: MRI - For brain tumour detection - For multiple exams - Best for soft tissues (e.g heart) CT - For solid tumours in the chest and abdomen - for bone abnormalities and injuries - cheaper than MRI Nuclear medicine This is a branch of medicine and medical imaging that uses radionuclides (unstable atoms) that undergo radioactive decay; it is used for the diagnosis and treatment of disease. Radionuclides are combined with other elements or medication to form radiopharmaceuticals. Nuclear medicine cont’d Radiopharmaceuticals localize in specific organs or cellular receptors so information can be obtained about diseases process/progress Nuclear medicine is based on cellular function and physiology rather than physical changes that are detected with X-rays and MRIs. Nuclear Medicine cont’d • Measures radiation emitted from within the body and provides information about the function of the organ, not just its structure • Large amounts of isotopes collect at site of damage “lighting” it up • Can be detected by special cameras • Ex. PET scan: positron emission tomography PET Produces a three-dimensional image of functional processes in the body. Gamma rays are emitted by a positron-emitting radionucleotide tracer, which is injected into the patient. Used for imaging of tumours and metastases, also for brain and heart function • PET scan are often used in combination with MRI or CT scans to give a complete metabolic and anatomic picture