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Radiology

Radiology

Field of medicine

Radiology (from Latin radius "ray" + λόγος "study, science") is a branch of medicine that studies the use of radiation methods for diagnosis (radiodiagnostics) and treatment (radiotherapy) of various diseases, as well as diseases and pathological conditions arising from exposure to ionizing radiation on the human body.

Many scientists contributed to the development of this direction: Röntgen, Becquerel, the spouses Marie and Pierre Curie, etc. Curies' hands were covered with wounds from constant contact with radioactive samples, which stimulated the idea of using radium in medical practice. Pierre Curie emphasized this fact in a Nobel speech delivered on June 5, 1905.

Originally, radiology was an aspect of medical science that deals with the use of electromagnetic energy emitted by X-ray machines or other similar devices to obtain imaging information for medical research. Radiology, which involves the use of x-rays, is called radiology. Today, medical imaging is no longer limited to the use of X-rays, but includes examinations with high frequency waves, magnetic fields, and other radiations

Medical uses

Since the body is made up of various substances with differing densities, Ionising and non-ionising radiation can be used to reveal the internal structure of the body on an image receptor by highlighting these differences using attenuation, or in the case of ionising radiation, the absorption of X-ray photons by the denser substances (like calcium-rich bones). The discipline involving the study of anatomy through the use of radiographic images is known as radiographic anatomy. Medical radiography acquisition is generally carried out by radiographers, while image analysis is generally done by radiologists. Some radiographers also specialise in image interpretation. Medical radiography includes a range of modalities producing many different types of image, each of which has a different clinical application.

Projectional radiography

The creation of images by exposing an object to X-rays or other high-energy forms of electromagnetic radiation and capturing the resulting remnant beam (or "shadow") as a latent image is known as "projection radiography." The "shadow" may be converted to light using a fluorescent screen, which is then captured on photographic film, it may be captured by a phosphor screen to be "read" later by a laser (CR), or it may directly activate a matrix of solid-state detectors (DR—similar to a very large version of a CCD in a digital camera). Bone and some organs (such as lungs) especially lend themselves to projection radiography. It is a relatively low-cost investigation with a high diagnostic yield. The difference between soft and hard body parts stems mostly from the fact that carbon has a very low X-ray cross section compared to calcium.

Computed tomography

Computed tomography or CT scan (previously known as CAT scan, the "A" standing for "axial") uses ionizing radiation (x-ray radiation) in conjunction with a computer to create images of both soft and hard tissues. These images look as though the patient was sliced like bread (thus, "tomography"-- "tomo" means "slice"). Though CT uses a higher amount of ionizing x-radiation than diagnostic x-rays (both utilising X-ray radiation), with advances in technology, levels of CT radiation dose and scan times have reduced. CT exams are generally short, most lasting only as long as a breath-hold, Contrast agents are also often used, depending on the tissues needing to be seen. Radiographers perform these examinations, sometimes in conjunction with a radiologist (for instance, when a radiologist performs a CT-guided biopsy).

Dual energy X-ray absorptiometry

DEXA, or bone densitometry, is used primarily for osteoporosis tests. It is not projection radiography, as the X-rays are emitted in 2 narrow beams that are scanned across the patient, 90 degrees from each other. Usually the hip (head of the femur), lower back (lumbar spine), or heel (calcaneum) are imaged, and the bone density (amount of calcium) is determined and given a number (a T-score). It is not used for bone imaging, as the image quality is not good enough to make an accurate diagnostic image for fractures, inflammation, etc. It can also be used to measure total body fat, though this is not common. The radiation dose received from DEXA scans is very low, much lower than projection radiography examinations.

Fluoroscopy

Fluoroscopy is a term invented by Thomas Edison during his early X-ray studies. The name refers to the fluorescence he saw while looking at a glowing plate bombarded with X-rays.

The technique provides moving projection radiographs. Fluoroscopy is mainly performed to view movement (of tissue or a contrast agent), or to guide a medical intervention, such as angioplasty, pacemaker insertion, or joint repair/replacement. The latter can often be carried out in the operating theatre, using a portable fluoroscopy machine called a C-arm. It can move around the surgery table and make digital images for the surgeon. Biplanar Fluoroscopy works the same as single plane fluoroscopy except displaying two planes at the same time. The ability to work in two planes is important for orthopedic and spinal surgery and can reduce operating times by eliminating re-positioning.

Angiography

Angiography is the use of fluoroscopy to view the cardiovascular system. An iodine-based contrast is injected into the bloodstream and watched as it travels around. Since liquid blood and the vessels are not very dense, a contrast with high density (like the large iodine atoms) is used to view the vessels under X-ray. Angiography is used to find aneurysms, leaks, blockages (thromboses), new vessel growth, and placement of catheters and stents. Balloon angioplasty is often done with angiography.

Contrast radiography

Contrast radiography uses a radiocontrast agent, a type of contrast medium, to make the structures of interest stand out visually from their background. Contrast agents are required in conventional angiography, and can be used in both projectional radiography and computed tomography (called "contrast CT").

Other medical imaging

Although not technically radiographic techniques due to not using X-rays, imaging modalities such as PET and MRI are sometimes grouped in radiography because the radiology department of hospitals handle all forms of imaging. Treatment using radiation is known as radiotherapy.

Industrial radiography

Industrial radiography is a method of non-destructive testing where many types of manufactured components can be examined to verify the internal structure and integrity of the specimen. Industrial Radiography can be performed utilizing either X-rays or gamma rays. Both are forms of electromagnetic radiation. The difference between various forms of electromagnetic energy is related to the wavelength. X and gamma rays have the shortest wavelength and this property leads to the ability to penetrate, travel through, and exit various materials such as carbon steel and other metals. Specific methods include industrial computed tomography.

Image quality

Image quality will depend on resolution and density. Resolution is the ability an image to show closely spaced structure in the object as separate entities in the image while density is the blackening power of the image. Sharpness of a radiographic image is strongly determined by the size of the X-ray source. This is determined by the area of the electron beam hitting the anode. A large photon source results in more blurring in the final image and is worsened by an increase in image formation distance. This blurring can be measured as a contribution to the modulation transfer function of the imaging system. The memory devices used in large-scale radiographic systems are also very important. They work efficiently to store the crucial data of contrast and density in the radiography image and produce the output accordingly. Smaller capacity memory drives with high-density connectors are also important to deal with internal vibration or shock.

Radiation dose

The dosage of radiation applied in radiography varies by procedure. For example, the effective dosage of a chest x-ray is 0.1 mSv, while an abdominal CT is 10 mSv.[7] The American Association of Physicists in Medicine (AAPM) have stated that the "risks of medical imaging at patient doses below 50 mSv for single procedures or 100 mSv for multiple procedures over short time periods are too low to be detectable and may be nonexistent." Other scientific bodies sharing this conclusion include the International Organization of Medical Physicists, the UN Scientific Committee on the Effects of Atomic Radiation, and the International Commission on Radiological Protection. Nonetheless, radiological organizations, including the Radiological Society of North America (RSNA) and the American College of Radiology (ACR), as well as multiple government agencies, indicate safety standards to ensure that radiation dosage is as low as possible.

Timeline

Further Resources

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News

Title
Author
Date
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Science X staff
May 7, 2021
phys.org
New research led by a team at Massachusetts General Hospital (MGH) points to a promising strategy to boost tumors' intake of cancer drugs, thereby increasing the effectiveness of chemotherapy treatments. The group's findings are published in Nature Nanotechnology.
April 7, 2021
clinicaltrials.gov
Artificial Intelligence - SARS-CoV-2 Risk Evaluation - Full Text View.
European Congress of Radiology
March 4, 2021
www.prnewswire.com:443
/PRNewswire/ -- The Lancet Oncology Commission on Medical Imaging and Nuclear Medicine, launched today during the European Congress of Radiology 2021, presents...
Sowmya Ramasubramanian
January 28, 2021
The Hindu
Facebook has used large amounts of non-COVID chest X-ray data to train a neural network to extract information. And the company said it has open-sourced the models.
January 13, 2021
WebWire
A special issue of the Journal of the American College of Radiology ( JACR ), published by Elsevier, challenges conventional wisdom across the imaging community. This collection of articles, the "Provocative Issue," presents extreme opinions on pressing issues confronting radiologists with the deliberate aim of sparking positive dialog and debate that will lead to innovative solutions to improve patient care and imaging-related outcomes. The issue is guest-edited by: , , , , , , • Caroli...
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