Radiologic technologist

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A radiologic technologist, also known as medical radiation technologist[1] and as radiographer,[2] performs imaging of the human body for diagnosis or treating medical problems. Radiologic technologists work in hospitals, clinics, and private practice.

Nature of the work[edit]

A radiologic technologist uses his/her expertise and knowledge of patient handling, physics, anatomy, physiology, pathology and radiology to assess patients, develop optimal radiologic techniques and evaluate resulting radiographic images.

The allied medical professions include many branches, such as respiratory therapist, physical therapist, surgical technologist, and others. The branch of the allied health field known as radiologic technology also has its own sub-specialties.The term sub-specialties has been a matter of debate and is a little confusing when a person going to a radiological program and observes that there are two other forms of medical imaging that are not radiological in nature i.e sonography and MRI. The term radiologic technologist is a general term relating to various sub-specialties within this field. Titles used to describe the nature of the work vary and include nuclear medicine technologist, radiographer, and radiation therapist.

Radiologic technology modalities (or specialties):

  • Diagnostic radiography – utilizes ionizing radiation in the examination of internal organs, bones, cavities and foreign objects; includes cardiovascular imaging and interventional radiography.
  • Fluoroscopy –utilizes ionizing radiation and direct imaging (constant radiation) used to dynamically visualize the digestive system, monitor the administration of contrast agents to highlight vessels and organs, or to help position devices within the body (such as pacemakers, guidewires, stents, etc.).
  • CT (computed tomography) – which provides cross-sectional views (slices) of the body; can also reconstruct additional images from those taken to provide more information in either 2 or 3D.
  • Nuclear medicine – uses radioactive tracers which can be administered to examine how the body and organs function, for example the kidneys or heart. Certain radioisotopes can also be administered to treat certain cancers, such as thyroid cancer.
  • Radiotherapy – uses radiation to shrink, and sometimes eradicate, cancerous cells/growths in and on the body.
  • Mammography – uses low dose ionizing radiation systems to produce images for the diagnosis of breasts disease,
  • Registered Radiologist Assistant (R.R.A.) a new advanced practice Radiographer career path in the United States for experienced Technologists. R.R.A.s do not interpret films/images/studies in the manner of the Reporting Radiographer [3] and the role has been accepted by the American College of Radiology (ACR) [4]

As with all other occupations in the medical field, radiologic technologists have rotating shifts that include night duties.

Education[edit]

Education varies worldwide due to legal limitations on the scope of the practice from country to country.

United States[edit]

Formal training programs in radiography range in length that leads to a certificate, an associate or a bachelor's degree. The American Registry of Radiologic Technologists (ARRT)- the primary credentialing organization for Radiologic Technologists in the United States- requires that candidates for ARRT Certification Exams must have an Associate's degree at minimum as of January, 2015, effectively ending non-degree granting diploma programs.[5] Accreditation is primarily through The Joint Review Committee on Education in Radiologic Technology (JRCERT)- the only agency recognized by the United States Department of Education and the Council for Higher Education Accreditation to grant accreditation to both traditional and online programs in Radiography, Radiation Therapy, Magnetic Resonance Imaging, and Medical Dosimetry. An online page where prospective students can check the accreditation of programs is maintained by JRCERT.[6]

Radiologic Technology students receive training in human anatomy and physiology, physics, mathematics, radiopharmacology, pathology, biology, research, nursing procedures, medical imaging science, diagnosis, radiologic instrumentation, emergency medical procedures, medical imaging techniques, computer programming, patient care, medical ethics and general chemistry. Schooling also includes significant amounts of documented practicum supervised by Registered Technologists in various clinical settings where the classroom theory is translated to practical knowledge and real world experience. The change from Film to Digital imaging has changed training as film quality assurance and quality control is largely obsolete. The role of computer workstations to produce synthetic images for Radiologists has steadily increased the need for computer skills as has electronic medical record software.

After primary training and licensure, continuing education is required to maintain licensure and certification with the ARRT, who sets the accepted national guidelines. The ARRT requires 24 Units of accredited continuing education every two years and the laws and the regulations of most states accept this standard. Continuing formal education or the passing of an advanced practice speciality exam may also be accepted for continuing education credit. The American Society of Radiologic Technologists (ASRT),[7] a professional association for people in Medical Imaging and Therapy, offers members and others continuing education materials in various media that meet the requirements of the ARRT for continuing education.[8] Additional requirements are set forth for technologists who specialize in mammography by the US FDA.[9]

A new and evolving career for Radiologic Technologists is that of the Registered Radiologist Assistant (R.R.A.) [10] who is an experienced Technologist- not a Physician Assistant- who has completed additional education, training and has passed exams to function as radiologist extenders.[11][12] A list of the 9 currently accredited R.R.A. programs is maintained by the ARRT and can be accessed online.[13] Candidates for the R.R.A. certification must possess a Bachelor of Science Degree at minimum.

United Kingdom[edit]

In the United Kingdom, radiologic technologists are known as Diagnostic Radiographers. The terms "Radiographer", "Diagnostic Radiographer" and "Therapy Radiographer" are protected titles within the United Kingdom and can not be used by any persons who has not undertaken formal study and registered with the Health Professions Council. The titles are protected by law. They must gain a university degree in Diagnostic Radiography/Diagnostic Imaging and be registered with the Health Professions Council (HPC) before they can undertake medical radiography. Degrees are offered by universities across the UK and last for 3 years in England and Wales, and 4 years in Scotland.[clarification needed]

Student (Trainee) Diagnostic Radiographers must spend a significant amount of time working at a hospital affiliated with the university (clinical placement) during their studies to meet the requirement for registration with the HPC. They specialise in the acquisition of radiographs (X-rays) and work with GP patients, Outpatients, A&E referrals and inpatients. They conduct mobile X-rays on wards and in other departments where patients are too critical to be moved and work as part of the operating team in mainly orthopaedic and urology cases, offering surgeons live radiographic imaging. Once qualified, diagnostic radiographers are able to acquire X-rays without supervision and work as part of the imaging team. They will have basic head examination qualifications with Computed Tomography (CT) and even basic experience with Magnetic Resonance Imaging (MRI), Ultrasound and Nuclear Medicine.

Negatoscope

Diagnostic Radiographers can specialise in-house or through a university course as a postgraduate in CT, MRI, Ultrasound or Nuclear Medicine with opportunities to gain an MSc in their field. Diagnostic Radiographers in the UK are also taking on roles that were typically only undertaken by the radiologist (a medical doctor who specialised in interpreting X-rays) in the past. Reporting Radiographers now write reports and diagnose pathologies seen on X-rays after completing a recognised HPC and Society of Radiographers (SoR), university course.

Risks[edit]

  • Epidemiological studies indicate that radiologic technologists employed before 1950 are at increased risk of leukemia and skin cancer, most likely due to the lack of use of radiation monitoring and shielding.[14]
  • Ionizing radiation, used in a variety of imaging procedures, can damage cells. Lead shields are used on the patient and by the radiologic technologist to reduce exposure by shielding areas that do not need to be imaged from the radiation source. While lead is highly toxic, the shields used in medical imaging are coated to prevent lead exposure and are regularly tested for integrity.[15]
  • Theoretically, the strong static magnetic fields of MRI scanners can cause physiological changes. After a human neural cell culture was exposed to a static magnetic field for 15 minutes, changes in cell morphology occurred along with some modifications in the physiological functions of those cells. However, these effects have not yet been independently replicated or confirmed, and this particular study was performed in vitro.[18]
  • Ultrasound imaging can deform cells in the imaging field, if those cells are in a fluid. However, this effect is not sufficient to damage the cells.[19]
  • As with any allied health professional, exposure to infectious diseases is likely, and proper precautions such as sterile technique must be employed to reduce the risk of infection.

References[edit]

  1. ^ CAMRT > Home Page. Camrt.ca. Retrieved on 2012-01-27.
  2. ^ AIR. AIR. Retrieved on 2012-01-27.
  3. ^ http://www.acr.org/~/media/ACR/Documents/PDF/QualitySafety/Resources/Radiologist%20Assistant/DevelopmentOfRA.pdf
  4. ^ http://www.acr.org/~/media/ACR/Documents/PDF/QualitySafety/Resources/Radiologist%20Assistant/JointPolicyStatement.pdf
  5. ^ https://www.arrt.org/Education
  6. ^ https://portal.jrcertaccreditation.org/summary/accreditedprogramsearch.aspx
  7. ^ http://www.asrt.org/main/about-asrt
  8. ^ http://www.asrt.org/main/continuing-education/earn-ce
  9. ^ https://www.xraycert.com/rad-tech-talk/arrt-ce-credits
  10. ^ http://www.acr.org/quality-safety/resources/radiologist-assistant
  11. ^ http://www.asrt.org/main/careers/radiologist-assistant
  12. ^ https://www.arrt.org/FAQ/RRA
  13. ^ https://www.arrt.org/RRA/Educational-Programs
  14. ^ Yoshinaga, S.; Mabuchi, K.; Sigurdson, A. J.; Doody, M. M.; Ron, E. (2004). "Cancer Risks among Radiologists and Radiologic Technologists". Radiology 233 (2): 313–21. doi:10.1148/radiol.2332031119. PMID 15375227. 
  15. ^ Lead Garments (Aprons, Gloves, etc.). Hps.org (2011-08-27). Retrieved on 2012-01-27.
  16. ^ Metabisulphite-induced occupational asthma in a radiographer. doi:10.1183/09031936.05.00024304. 
  17. ^ Batch, James; Nowlan, Patrick (2003). "Legal Issues in Radiography: Darkroom Disease". Legal Issues in Business 5. 
  18. ^ Formica, Domenico; Silvestri, Sergio (2004). "Biological effects of exposure to magnetic resonance imaging: an overview". BioMedical Engineering OnLine 3: 11. doi:10.1186/1475-925X-3-11. PMC 419710. PMID 15104797. 
  19. ^ Zinin, Pavel; Allen, John (2009). "Deformation of biological cells in the acoustic field of an oscillating bubble". Physical Review E 79 (2). doi:10.1103/PhysRevE.79.021910.