HealthView: Behind the X-ray
X-Ray. MRI. CAT scan. PET scan. Ultrasound. Mammography. Nuclear medicine. Most people at one time or another have had one of these procedures. Radiology, or imaging as it’s often called, by definition is the science of high-energy radiation for the diagnosis and treatment of disease. In today’s radiology practice we use a variety of imaging tools such as radiofrequency, magnetic fields, and ultrasound, beta and positron emissions.
Medical Imaging is relatively new considering how long the practice of medicine has been around. Most famously, Marie Curie died in 1934 due to radiation exposure during the course of her scientific research in radiology and her radiological work at field hospitals during World War I. Now, 85 years later, the field of radiology continues to push the boundaries of technology in medicine, such as expanding the parameters of 3D imaging to reveal details not seen before, computer-aided detection and artificial intelligence leading to increased accuracy and reduced call-back rates.
As a radiologist, my days are spent looking at the very small details of the medical images of which it is my responsibility to analyze and locate abnormalities. I look for clues, such as patterns or subtle changes in patterns that can help lead me down a path of diagnosis. My time is further spent obtaining histories from patient interviews and electronic medical records, preparing reports of my findings, performing diagnostic procedures, reviewing information and communicating those results back to your primary care physician, provider or specialist.
These days, you should look for radiologists who are fellowship trained, meaning we have undergone additional training on top of four years of medical school and four or five years of residency to further specialize in a particular area of medical imaging. Fellowship training is the difference between someone who knows the basics of all general radiology and someone who knows all of general radiology and in addition specializes in a certain imaging type such as MRI imaging, muscular-skeletal or neuroradiology (brain and nerves).
As a patient, it can be hard to tell what kind of imaging procedure you need based on name alone. Below is a list of the some common imaging exams and what each is typically used for:
An X-ray is a test that produces two dimensional imaging. As X-ray beams pass through the body they are absorbed in different amounts depending on the density of materials they pass through. Dense materials, such as bone and metal, show up as white on X-rays. The air in your lungs shows up as black. Fat and muscle appear as shades of gray. X-rays are commonly used to diagnosis fractures and some lung disease.
A CAT scan, also known as a CT scan, is a form of X-ray that can make 3D images and cross-sectional anatomy images, or makes pictures of the body that can be viewed like taking a piece of bread out of a loaf. CT stands for computed tomography and is typically used for bone fractures, tumors, cancer monitoring and finding internal bleeding. CAT scans are typically faster than MRIs and can provide pictures of tissues, organs and skeletal structure.
MRI (magnetic resonance imaging) also makes 3D and cross-sectional images. MRI uses a large magnet and radio waves to make detailed pictures of organs and structures within the body. Unlike X-rays and CAT scans, MRIs do not use ionizing radiation. MRIs are useful for examining the brain and spinal cord, and are frequently used to diagnose issues with joints, the brain, wrists, ankles, breasts, heart and blood vessels.
A PET scan, or positron emission tomography, uses a special dye containing radioactive tracers. These tracers are targeted to certain tissues depending on the study. The tracer will collect in areas of higher chemical activity, showing up as bright spots on a PET scan. PET scans can measure blood flow and oxygen use, making them suited to detect cancer or brain disorders. PET scans work on function of the body. CAT scans and MRIs are better at imaging anatomy.
Elena Motuzko, M.D., is a fellowship-trained radiologist at Mountain Radiology. Dr. Motuzko graduated from Baylor College of Medicine in Houston, Texas, and completed her residency at Cooper University Hospital in Camden, New Jersey. A neuroradiology fellowship at Yale provided Dr. Motuzko with expertise and experience in the latest advancements in radiology technology. For more information on Imaging at Valley View, visit vvh.org/imaging.
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