Radiology is a specialty that uses Medical imaging to diagnose and treat diseases seen within the

body. A variety of imaging techniques such as X-ray radiography, ultrasound, computed

tomography (CT), nuclear medicine including positron emission tomography (PET), and magnetic
resonance imaging (MRI) are used to diagnose and/or treat diseases. Interventional radiology is the
performance of (usually minimally invasive) medical procedures with the guidance of imaging
technologies.
The acquisition of medical images is usually carried out by the Radiographer, often known as a
Radiologic Technologist. Depending on location, the Diagnostic Radiologist, or Reporting Radiographer,
then interprets or "reads" the images and produces a report of their findings and impression or
diagnosis. This report is then transmitted to the Clinician who requested the imaging, either routinely or
emergently. Imaging exams are stored digitally in the picture archiving and communication
system (PACS) where they can be viewed by all members of the healthcare team within the same health
system and compared later on with future imaging exams.
Contents
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1Diagnostic imaging modalities

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1.1Projection (plain) radiography

1.2Fluoroscopy

1.3Computed tomography

1.4Ultrasound

1.5Magnetic resonance imaging

1.6Nuclear medicine

2Interventional radiology

3Teleradiology

4Professional training
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4.1United States

4.2United Kingdom

4.3Germany

4.4Italy

4.5The Netherlands

5See also

6References

7External links

Diagnostic imaging modalities[edit]

Projection (plain) radiography[edit]
Main article: Projectional radiography

Madura foot X-ray

Radiography of knee in DR-machine at Sandnessjen Hospital, Norway.

Radiographs (originally called roentgenographs, named after the discoverer of X-rays, Wilhelm Conrad
Rntgen) are produced by transmitting X-rays through a patient. The X-rays are projected through the
body onto a detector; an image is formed based on which rays pass through (and are detected) versus
those that are absorbed or scattered in the patient (and thus are not detected). Rntgen discovered Xrays on November 8, 1895 and received the first Nobel Prize in Physics for their discovery in 1901.
In film-screen radiography, an X-ray tube generates a beam of X-rays, which is aimed at the patient. The
X-rays that pass through the patient are filtered through a device called an grid or X-ray filter, to reduce
scatter, and strike an undeveloped film, which is held tightly to a screen of light-emitting phosphors in a
light-tight cassette. The film is then developed chemically and an image appears on the film. Film-screen
radiography is being replaced by computed radiography (CR) but more recently by digital
radiography (DR) and the EOS imaging.[1] In the two latest systems, the X-rays strike sensors that
converts the signals generated into digital information, which is transmitted and converted into an image

displayed on a computer screen. In digital radiography the sensors shape a plate, but in the EOS
system, which is a slot-scanning system, a linear sensor vertically scans the patient.
Plain radiography was the only imaging modality available during the first 50 years of radiology. Due to
its availability, speed, and lower costs compared to other modalities, radiography is often the first-line
test of choice in radiologic diagnosis. Also despite the large amount of data in CT scans, MR scans and
other digital-based imaging, there are many disease entities in which the classic diagnosis is obtained
by plain radiographs. Examples include various types of arthritis and pneumonia, bone tumors
(especially benign bone tumors), fractures, congenital skeletal anomalies, etc.
Mammography and DXA are two applications of low energy projectional radiography, used for the
evaluation for breast cancer and osteoporosis, respectively.

Fluoroscopy[edit]
Main article: Fluoroscopy
Fluoroscopy and angiography are special applications of X-ray imaging, in which a fluorescent screen
and image intensifier tube is connected to a closed-circuit television system. [2]:26 This allows real-time
imaging of structures in motion or augmented with a radiocontrast agent. Radiocontrast agents are
usually administered by swallowing or injecting into the body of the patient to delineate anatomy and
functioning of the blood vessels, the genitourinary system, or the gastrointestinal tract (GI tract). Two
radiocontrast agents are presently in common use. Barium sulfate (BaSO 4) is given orally or rectally for
evaluation of the GI tract. Iodine, in multiple proprietary forms, is given by oral, rectal, intra-arterial or
intravenous routes. These radiocontrast agents strongly absorb or scatter X-rays, and in conjunction
with the real-time imaging, allow demonstration of dynamic processes, such as peristalsis in the
digestive tract or blood flow in arteries and veins. Iodine contrast may also be concentrated in abnormal
areas more or less than in normal tissues and make abnormalities (tumors, cysts, inflammation) more
conspicuous. Additionally, in specific circumstances, air can be used as a contrast agent for the
gastrointestinal system and carbon dioxide can be used as a contrast agent in the venous system; in
these cases, the contrast agent attenuates the X-ray radiation less than the surrounding tissues.

Computed tomography[edit]
Main article: X-ray computed tomography

Image from a CT scan of the brain

CT imaging uses X-rays in conjunction with computing algorithms to image the body.[3] In CT, an X-ray
tube opposite an X-ray detector (or detectors) in a ring-shaped apparatus rotate around a patient,
producing a computer-generated cross-sectional image (tomogram). CT is acquired in the axial plane,
with coronal and sagittal images produced by computer reconstruction. Radiocontrast agents are often
used with CT for enhanced delineation of anatomy. Although radiographs provide higher spatial

resolution, CT can detect more subtle variations in attenuation of X-rays. CT exposes the patient to
more ionizing radiation than a radiograph.
Spiral multidetector CT uses 16, 64, 254 or more detectors during continuous motion of the patient
through the radiation beam to obtain fine detail images in a short exam time. With rapid administration of
intravenous contrast during the CT scan, these fine detail images can be reconstructed into threedimensional (3D) images of carotid, cerebral, coronary or other arteries.
The introduction of computed tomography in the early 1970s revolutionized diagnostic radiology by
providing Clinicians with images of real three-dimensional anatomic structures. CT scanning has
become the test of choice in diagnosing some urgent and emergent conditions, such as cerebral
hemorrhage, pulmonary embolism (clots in the arteries of the lungs), aortic dissection (tearing of the
aortic wall), appendicitis, diverticulitis, and obstructing kidney stones. Continuing improvements in CT
technology, including faster scanning times and improved resolution, have dramatically increased the
accuracy and usefulness of CT scanning, which may partially account for increased use in medical
diagnosis.

Ultrasound[edit]
Main article: Ultrasound
Medical ultrasonography uses ultrasound (high-frequency sound waves) to visualize soft tissue
structures in the body in real time. No ionizing radiation is involved, but the quality of the images
obtained using ultrasound is highly dependent on the skill of the person (ultrasonographer) performing
the exam and the patient's body size. Examinations of larger, overweight patients may have a decrease
in image quality as their subcutaneous fat absorbs more of the sound waves. This results in fewer sound
waves penetrating to organs and reflecting back to the transducer, resulting in loss of information and a
poorer quality image. Ultrasound is also limited by its inability to image through air pockets (lungs, bowel
loops) or bone. Its use in medical imaging has developed mostly within the last 30 years. The first
ultrasound images were static and two-dimensional (2D), but with modern ultrasonography, 3D
reconstructions can be observed in real time, effectively becoming "4D".
Because ultrasound imaging techniques do not employ ionizing radiation to generate images (unlike
radiography, and CT scans), they are generally considered safer and are therefore more common
in obstetrical imaging. The progression of pregnancies can be thoroughly evaluated with less concern
about damage from the techniques employed, allowing early detection and diagnosis of many fetal
anomalies. Growth can be assessed over time, important in patients with chronic disease or pregnancyinduced disease, and in multiple pregnancies (twins, triplets, etc.). Color-flow Doppler ultrasound
measures the severity of peripheral vascular disease and is used by cardiologists for dynamic
evaluation of the heart, heart valves and major vessels. Stenosis, for example, of the carotid
arteries may be a warning sign for an impending stroke. A clot, embedded deep in one of the inner veins
of the legs, can be found via ultrasound before it dislodges and travels to the lungs, resulting in a
potentially fatal pulmonary embolism. Ultrasounds is useful as a guide to performing biopsies to
minimise damage to surrounding tissues and in drainages such as thoracentesis. Small, portable
ultrasound devices now replace peritoneal lavage in trauma wards by non-invasively assessing for the
presence of internal bleeding and any internal organ damage. Extensive internal bleeding or injury to the
major organs may require surgery and repair.