Radiology & Radiography Overview

• Medical radiation sciences uses energy to create images of the human body.
• Various energy forms may be used depending on the application in medical imaging.
• Some energies can create ionizations in human tissue during medical imaging.
• Radiation is energy transmitted by waves through space or matter.
• Ionization occurs when a neutral atom gains or loses an electron, resulting in a net charge.

Energy Forms for Imaging

• Sound is an energy form used in medical sonography.
• Electrical energy is used in electrocardiography and electroencephalography.
• Heat (thermal) energy is utilized in thermography.
• Magnetic/Radio Wave energy is used in magnetic resonance imaging.
• Electromagnetic energy is used in imaging.
• X-rays and radio waves are forms of energy used in imaging.
• Nuclear energy and nuclear medicine technology (Gamma radiation) are used in imaging.

Imaging Science

• 'Imaging science' is preferred over 'radiologic sciences' because it includes technologies that do not involve radiation, such as U/S & MRI.

Medical Sonography

• High-frequency sound energy is used to create medical images.
• Medical sonography does not create ionizations.
• Medical sonography has a wide variety of medical applications.

Magnetic Resonance Imaging

• Magnetic resonance imaging uses the energy of high-strength magnetic fields and radio waves to create images of the human body.
• Magnetic resonance imaging creates no ionizations.

CT Scanning

• X-ray energy and sophisticated software are used to create images of the human body.

Nuclear Medicine

• Nuclear medicine uses the energy of the atom to create medical images.
• The energy form is gamma radiation.
• Radioactive isotopes are used to create gamma radiation.

Radiation Therapy

• High-energy ionizing radiation is used to treat malignant tumors (cancer).
• Radiation therapists work with other team members to improve the quality of life of cancer patients.

Cardiovascular Interventional Imaging

• X-rays are used to visualize human blood vessels and heart anatomy.
• A catheter and the injection of x-ray contrast material are required to visualize anatomy.

Radiography

• Records or radiographs of the internal structures of the body are created.
• Electromagnetic energy in the form of x-rays is used to create medical images.

X-Rays

• X-rays are also known as Roentgen rays.

History of Radiology

• Wilhelm C. Röngten discovered x-rays on November 8, 1895.
• Röngten received the Nobel Prize in Physics in 1901.
• The first known x-ray image was of his wife's hand.

Radiologic Sciences as a Career

• A wide variety of career paths are available in radiologic sciences.
• Careers often begin with a general radiography background.
• Specialty areas require additional education and certification.
• Career opportunities are nearly limitless and demand initiative and a desire for professional success.

Career Opportunities

• Radiography
• CT Scanning
• Medical Sonography
• Radiation Therapy
• Medical dosimetrist
• MRI Scanning
• Mammography
• Bone densitometry
• DEXA Scanning
• Radiologist Assistant
• Nuclear Medicine
• Cardiovascular
• Interventional Technology
• PACS Administrator
• Radiology Administration
• Education
• Research
• Commercial Firms
• Sales
• Applications
• Service

Radiographers

• Radiographers use x-rays to create images of bones and body parts.
• Upon passing the ARRT examination, a technologist can place the initials RT (R) after their name.

Radiopharmaceuticals

• Radiopharmaceuticals are radioactive materials, tracers, or radioactive solutions that can be administered intravenously, orally, or by inhalation.

Technician vs. Technologist

• Training of a technologist typically involves a higher level of problem-solving skill and more extensive education compared to a technician.

Radiology

• Radiology can be referred to by a number of different names, including X-ray, medical imaging, diagnostic services, and imaging services.
• Radiology is predominantly a diagnostic service that focuses on imaging patients to diagnose their medical condition.

Health Care Team

• Team members include physicians, nurses, allied health professionals, supporting members, and nonclinical staff.
• Most health careers are referred to as allied health.
• Hospitals are communities within communities.

Conclusion

• X-rays were discovered by W.C. Röngten in 1895.
• Medical imaging consists of many diagnostic areas involving energy, particularly radiant energy.
• Radiologic sciences professionals perform as essential members of a healthcare team.
• Career opportunities are nearly limitless and demand initiative and a desire for professional success.

General Classifications of Organizations

• Accreditation
• Certification
• Licensure
• Professional Organizations

Accreditation

• Accreditation is a process to ensure high quality of operations and offerings.
• It is a voluntary, peer review-process.
• It involves several areas within health care.

Accreditation of Schools

• Joint Review Committee on Education in Radiologic Technology (JRCERT)
• Joint Review Committee on Education in Diagnostic Medical Sonography (JRCDMS)
• Joint Review Committee on Education in Nuclear Medicine Technology (JRCNMT)
• Joint Review Committee on Education in Cardiovascular Technology

JRCERT

• Established in 1969.
• Board members are nominated by four professional organizations concerned with radiology education.
• Currently accredits programs in Radiography, Radiation Therapy Technology, Medical Dosimetry, and Magnetic Resonance Imaging.
• JRCERT is concerned with compliance with education standards developed by and for the profession of radiologic technology.
• Governed by a Board of Directors known as the Joint Review Committee.
• JRCERT accreditation requires demonstrated compliance with minimum requirements known as Essentials and Guidelines or Standards.

JRCDMS

• Concerned with compliance with education standards developed by and for the profession of medical sonography.
• Established in 1979 and is sponsored by nine organizations.
• Currently accredits approximately 170 institutions dealing with medical sonography.

JRCNMT

• Concerned with compliance with education standards developed by and for the profession of nuclear medicine technology.
• Established in 1970 and is sponsored by four organizations.
• Currently accredits approximately 100 nuclear medicine technology programs.

JRC-CVT

• Deals with programs seeking accreditation in cardio-vascular imaging.
• Also provides national accreditation through Commission on Accreditation of Allied Health Education Programs (CAAHE).
• Established in 1985.
• Currently is sponsored by 6 organizations

Certification

• Certification deals with the demonstration of minimum competencies in recognized professional skills and knowledge.
• Generally, competency is demonstrated by a test.
• It is a voluntary process and highly sought after by professionals within health care.
• Individuals are responsible to achieve and maintain professional certification. Certifications:
  • Radiography (R)
  • Nuclear medicine technology (N)
  • Radiation therapy technology (T)
  • General sonography (S), vascular sonography (VS), breast sonography (BS)
  • CT scanning (CT)
  • MRI scanning (MR)
  • Cardiac interventional technology (CI)
  • Vascular interventional technology (VI)
  • Quality management (QM)
  • Bone densitometry (BD)
  • Radiologist assistant (RA)
• Certified professionals are listed in a national registry as proof of achievement.
• Certification provides the privilege of displaying professional credentials as earned, which require ongoing continuing education

Popular Certification Agencies in Medical Imaging

Agencies:

• American Registry of Radiologic Technologists (ARRT)
• American Registry of Diagnostic Medical Sonographers (ARDMS)
• Nuclear Medicine Technology Certification Board (NMTCB)
• American Registry of Radiologic Technologists (ARRT) was founded in 1922 and has website www.arrt.org.
• American Registry of Diagnostic Medical Sonographers (ARDMS) was founded in 1975 and has website www.ardms.org.
• Nuclear Medicine Technology Certification Board (NMTCB) was founded in 1977 and has website www.nmtcb.org.

State Licensing Agencies

• Some states may require state licensing to practice radiologic technology.
• State laws can vary greatly.
• Contact the ASRT for a current listing.
• Many states honor certification from a nationally recognized agency such as the ARRT.
• State licensing is also known as licensure

Professional Societies

• Professional societies represent the general welfare of their members.
• Professional duties may include education, scholarships, research and special reports, governmental affairs and appointments, and malpractice insurance plans.

ARRT Definition of Certification & Registration

• Certification: Meet all initial eligibility requirements.
• Registration: Meet all continuing eligibility requirements.

ARRT Examination Facts

• The ARRT examination has 200 graded and 30 pilot questions.
• Candidates have a 90-day window to schedule a test appointment.
• Candidates have a three-year window in which they are allowed three attempts to pass
• Candidates can appeal test administration up to two days after taking an exam

Continuing Education Requirement for the RTs

• Continuing education requirements bridge the gap between initial formal education and advanced practical needs.
• They prevent professional obsolescence.
• They assure the public that all technologists maintain competency.
• Requirements advance the profession through continuous growth of all technologists working in the field.
• They provide advanced growth opportunities for technologists through advanced preparation.

Continuing Education Requirements

• Mandatory proof of continuing education is required biannually (2-year) biennial increments.
• Credits run from the first day of your birth month to the last day of the month before your birth month two years later.
• 24 credits are needed each 24 months.

How to Document CE credits

• Document the date(s) of attendance.
• Document the topic/subject title.
• Document the content of the education opportunity.
• Document the Number of (50-min) contact hours.
• Document the Name of speaker/presenter.
• Document the Name/signature of sponsor or authorized representative.
• Document the CE-approved reference number when applicable.
• Documentation must be maintained for one year beyond the end of each biennium.
• Actual documentation does not accompany renewal forms. ARRT conducts random audits.

Noncompliance with CE

• Technologists not obtaining the necessary continuing education is considered on probation.
• Probation is granted only for 1 year of the next biennium.
• Further non-compliance during the next 12 months results in the loss of ARRT certification.
• Only Recognized Continuing Education Evaluation Mechanisms (RCEEMS) organizations can approve CE courses for RTs

Obtaining CE Credits

• Professional societies
• In-services education (done by the institutions where the technologist is employed)
• Private Companies

Continuing Qualification Requirements (CQR)

• All R.T.s, primary and post-primary certifications earned on or after January 1, 2011, are time-limited to 10 years.
• Recertification requires completion of the CQR process, and the very first CQR deadline is not until 2021.

Stress

• Stress is produced by life events that place a perceived demand on daily activities.
• Stress causes emotional and biologic changes in the body.

Fight or Flight Response

• Physiologic reaction to a real or imagined threat, arising from emotions of both fear and anger.
• Physiologic responses include increased metabolism of fats/sugars for energy, release of hormones, increased blood flow and cardiac output, and stimulated central nervous system.

What Happens to the Body During the Fight or Flight Response

• Heart rate gets faster, which increases oxygen flow to major muscles.
• Pain perception drops, and hearing sharpens.
• Blood pressure rises, and hormones rush into the bloodstream to send sugar to muscles and brain.
• Food digestion temporarily ceases so that more blood is available for energy.
• Typically, it takes 20 to 30 minutes for the body to return to normal and to calm down.

Stress and Education

• Radiologic and imaging sciences education offers new challenges with new technology, clinical experiences, caring for patients, and performing in a high-stress environment.
• Stressful events may come from family, friends, and employers/co-workers.

Strategies to Deal with Stress

• Important to maintain a positive self-image and understand the environment adding to your stress.
• Lessen or remove yourself from stressful situations.
• Adopt a strategy of positive thoughts and emotions.
• Politely say “no” to those who want to place extraordinary demands on you.

Signs of Stress

• Many signs are physiologic.
• Family and friends can often sense your stress.
• Emotions may be noticeably altered.
• Stressors vary from person to person.

Stressors

• Stressor is any event that adds stress to your life are unique to the individual.
• Best dealt with by buffering the stress event.
• Recognize that many stressors are outside your control.

Strategies to Deal with Stressors

• Know the difference between a stressor and a "hassle”.
• Plan positive activities to balance the effects of hassles and stressors.
• Avoid out-of-control language and replace with in-control language.
• Understand the “worry” process and that all stress can never be eliminated completely.

Worry Process

• Recognize when the worry process is in your vocabulary and thought processes.
• 95% of things you worry about never turn out the way you might expect them to.
• Many times, you worry about things out of our sphere of control.
• Procrastination is a “worry contributor.”

"Worry" Survival Techniques

• Avoid procrastination and recognize the events over which you have some degree of control.
• Understand that most worrisome events never turn out as you thought they would and don't build "worry mountains.”

Stressors

• Time, with little to no control over the amount of time available.
• Practice time management and avoid indecisiveness, set realistic completion timelines, and practice self-management.

Self-Management

• Know yourself.
• Prioritize your responsibilities and activities.
• Plan for self-care.

Stress Buffers

• Stress buffers can help reduce the harmful effects of stress.

Test-Taking Tips

• Take a "study-rest-day” the day before a major exam.
• Avoid last-minute cramming for exams.
• Wear bright, colorful clothes and avoid a heavy meal before exams.
• Get a good night's sleep, arrive early, and scan the test
• Answer the questions you know first and review carefully.
• Check test answer sheet and correlate with numbering.
• After the test is done, “let it go” and learn from the experience.

Critical Thinking

• Critical thinking involves sound professional judgment applied with high ethical standards and integrity
• Requires professional knowledge and experience.
• Medical imaging inherently requires critical thinking skills and are traits that employers expect.

Critical Thinking and Patient Care

• Each patient experience is unique, requiring adaptability, creativity, reflection, and self-assessment for improvement.

Critical Thinking in Learning

• Critical thinking requires more than just the simple recollection of knowledge and facts. and goes beyond memorization.
• Learning activities include problem-solving, role-playing, lab simulations, case studies, and situational judgment questions.
• Critical-thinking skills are best taught through analysis, application, and evaluation.

Problem-Solving and Critical-Thinking Steps

Steps:

• Identify and clarify the problem.
• Perform an objective analysis of the problem.
• Develop realistic solutions to the problem.
• Consider all viable solutions to the problem.
• Select the best solution to the problem, and implement it.
• Skills are taught in various learning settings and must involve personal values and attitudes.

Clinical Setting

• Requires thoroughly understand ethical responsibilities.
• Every patient experience is unique and requires adaptive measures.
• A complete comprehension of professional principles is essential.

Clinical Applications of Critical Thinking

• Clinical Applications of Critical Thinking Requires a thorough understanding and compliance with ethics. as well as technical competency.
• Interactions with patients as unique individuals is required
• Steps in critical thinking and problem solving:*
  • Identify the problem.
  • Investigate the problem, objectively.
  • Develop viable solutions.
  • Select the best solution and implement it.

Clinical Education

• Clinical setting allows for the integration of knowledge gained from didactic course work.
• Education includes cognitive, affective and psychomotor components.
• The purpose is to use the clinical setting to convert learning from settings to real-world patient experiences.

Learning Process

• Based on performance objectives.
• Learning observed and measured by way of competencies.
• Learning outcomes are essential to assessing competency and program effectiveness.

Taxonomy of Learning

• Cognitive domain: Deals with concepts, information, knowledge Affective domain: Deals with values, attitudes, emotions, feelings
• Psychomotor domain: Deals with connection between cognitive learning and motor skills

Competencies Classifications

• Mandatory and Elective clinical competencies in various exam categories must be completed and documented.
• ARRS Establishes minimum competencies

Competency Needed

• Ten mandatory general patient care procedures;
• Thirty Six mandatory imaging procedures
• Fifteen ElectiveImaging procedures

Education Policies

• Supervision
• Performance of Actual Examinations
• Simulations
• Assessments
• Radiation Protection Practices
• Professional Ethics
• Practice Standards
• HIPAA Professional Appearance and Behavior
• Attendance & Tardiness
• Pregnancy
• Disciplinary Procedures

3 Phases of Clinical Development

1. Observing: Watching someone else performing the procedure
2. Assistance: Actual performance of the procedure on the patient with help
3. Performance: Demonstrating ability to perform all independently

Direct Supervision

• Is provided by a certified radiographer and clinical instructor whose responsibilities are to: review consult to determine examination with students level of achievement,
• Evaluate condition of patient to student's knowledge and be physically present in radiography room when examination is performed and review the final radiographs.

Indirect Supervision

• Supervision is by certified radiographer who is immediately available to assist- regardless of skill level.
• "Immediately Available" is intepreted by the presense of radiographer in area where procedure is performed.
• The Radiographer should not be involved for risk or rendering the Radiographer not available.

Pregnancy Policy

• Disclosure is voluntary
• Strongly encouraged to declare
• Pregnancy can be withdrawn at any time in writing to Program director

Declared Pregnancy Student

Monitors

• Is not interrupted
• Withold flouroscope rotation until completed
• Continues with class participation
• Withdraws to reenter

Radiographic - Objectives

• Role of radiographer in maximizing diagnostic yield
• Identify the typical features of a radiographic system
• Explain radiographic equipment manipulation
• Collimation and importance to protection

Equipment objectives include

• Function of radiograph tables
• Explain major rad console console.
• Tube support Systems
• Phototimulator
• Receptor alignment
• Classes of Digital imaging
• R/F Design Changes
• mobile designs

Diagnostic Yield

• The amount of useful information for accurate diagnosis.

Imaging Modalities

Modalities Provide different perspectives

• Radiography, Flouoscopy
• Sonography, CT and MRI, and Nuclear Medicine

Diagnostic Efficacy

• The accuracy of diagnostic info
• Optimize standards of care

X Ray machine design features include

• Radiograph table
• Control-Upright image receptor
• Chest stand
• X-ray tube and x-ray support
• Collimator Assembly

Tube design Made for high Heat with a window for X-Radiation

• -Fixed height or four way Floating top table
• -Some have speed tilting
• • Uniform radioluscent surface

Tilting Designs

• Table tilts from horizontal to vertical to Trendelenburg Most have four way travel and dont have height functions

Bucky assembly

• Radiographic grid and try that oscilates for clear lines
• Interfaces system sophisticated electronic's button and exposure

Console Selects all exposure factor mA Time KVP Focus and AEC

Operating Console

Digital touch screen Body sizes with Icons Uses DR Detectors

Exposure Techniques

• 3 Factors -mA and KVP and Distances
• Focus and AEC

APR

Anatomically programmed

SWITCH Take The X-ray

TYPES SWITCHES

• deadman
• one motion

Components in external room

• Ceiling Support System
• Tube Housing and Rails
• Variable SID and Dent position
• Locks locks tube X-Ray Tube Supports

TWO Designs

• Floor Mount or - Ceiling Suspended
• Easy tube positioning patient assembly and ergonomics

Overhead crane

• tube travel -vertical travel and longitudinal and axis with head rotations

Components

Control the shape of the x-ray towards Patient High-intensity light field with manual PBL

Newer systems may Display image from last exposure movement OTC requires behind booth

• RECIEVE Remnent
• convert to signal as most - Digital system

Receptor is flat and Cassettes -DR-TETS or thin film

• Indiret - Direct

System Types

Radiography DR flat Detectors OR Computes reusable Plates

Fluoroscopy

• Provides real time Images Attached image receptor and Array with procedures Capable Images
• Consists r1

Radiation/fluoro systems

Capable Control Monitors

tilt

Mobile Unit

Used hospitals setting and motorized similiar fixed unit

X-rays

• High-frequency output • Limited power • Used to be plugged wall outlet for charging when not in use wireless portable exposure Switch

Components generator and C arms monitors ER/Clinics

• Uses electricity Pass and strikes a image X-ray Tube Electron Cathode Filament Accelerate GREAT speeds and voltage
• Stops and TRANSFORMS-

Tubes metal Housing passes through

LEAK radiation Dissipate Heat to preent great expanisom

cathode Function

• Negative part of the x-ray with filmament
• Cause current

Small and Large

Filaments metal

Coil Tungsten

Negative and conflined vital to produces radiation

• Anonde Stalter

WHY Tungsten

High melting point, high thermal for easy easy conduct to Heat electron strikes target

useful beam

window equal Intensity Heat

WHAT

The heating and KE of the anode tube doubles The heating and KE of THE tube

Heat

Too Fast GLASS cracks ELECTRICTY Balance

Prolonged Heating Causes Damage

Appropriate

Heat Dissipation

EXPOSURE to radiation transfer of ELECTROMAGNETIC radiation Heat exposure

Heat Conduction or from TOUCH

oil path or By HEAT to particle movement

Over Heat and warm to spread the heat of target for period periods

Know the Radtion is use Radiator REMnantabsorbed electronic data

This quiz covers the basics of radiology and radiography, including administration routes for radioactive tracers, roles of professionals in the field, and the discovery of X-rays. It also touches on the importance of supervision and pregnancy considerations in clinical rotations.