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All radiological work is done at the request of and under the supervision of a physician. Just as a prescription is required for certain drugs to be dispensed or administered, so must a physician's request be issued before a patient can receive any kind of imaging procedure.
There are four primary disciplines in which radiologic technologists may work: radiography (taking X-ray pictures or radiographs), nuclear medicine, radiation therapy, and sonography. In each of these medical imaging methods, the technologist works under the direction of a physician who specializes in interpreting the pictures produced by X-rays, other imaging techniques, or radiation therapy. Technologists can work in more than one of these areas. Some technologists specialize in working with a particular part of the body or a specific condition.
X-ray pictures, or radiographs, are the most familiar use of radiologic technology. They are used to diagnose and determine treatment for a wide variety of afflictions, including ulcers, tumors, and bone fractures. Chest X-ray pictures can determine whether a person has a lung disease. Radiologic technologists who operate X-ray equipment first help the patient prepare for the radiologic examination. After explaining the procedure, they may administer a substance that makes the part of the body being imaged more clearly visible on the film, video, or digital file. (Note: digital imaging technology is increasingly being used by imaging facilities today and may eventually replace film). They make sure that the patient is not wearing jewelry or other metal that would obstruct the X-rays. They position the person sitting, standing, or lying down so that the correct view of the body can be radiographed, and then they cover adjacent areas with lead shielding to prevent unnecessary exposure to radiation.
The technologist positions the X-ray equipment at the proper angle and distance from the part to be radiographed and determines exposure time based on the location of the particular organ or bone and thickness of the body in that area. The controls of the X-ray machine are set to produce pictures of the correct density, contrast, and detail. Placing the photographic film or digital recording device closest to the body part being x-rayed, the technologist takes the requested images, repositioning the patient as needed. Typically, there are standards regarding the number of views to be taken of a given body part. The film is then developed (or the video or digital file is prepared) for the radiologist or other physician to interpret.
In a fluoroscopic examination (a more complex imaging procedure that examines the gastrointestinal area), a beam of X-rays passes through the body and onto a fluorescent screen, enabling the physician to see the internal organs in motion. For these, the technologist first prepares a solution of barium sulfate to be administered to the patient, either rectally or orally, depending on the exam. The barium sulfate increases the contrast between the digestive tract and surrounding organs, making the image clearer. The technologist follows the physician's guidance in positioning the patient, monitors the machine's controls, and takes any follow-up radiographs as needed.
Radiologic technologists may learn other imaging procedures such as computed tomography (CT) scanning, which uses X-rays to get detailed cross-sectional images of the body's internal structures, and MRI, which uses radio waves, powerful magnets, and computers to obtain images of body parts. These diagnostic procedures have become more common and usually require radiologic technologists to undergo additional on-the-job training.
Other specialties within the radiography discipline include mammography and cardiovascular interventional technology. In addition, some technologists may focus on radiography of joints and bones, or they may be involved in such areas as angiocardiography (visualization of the heart and large blood vessels) or neuroradiology (the use of radiation to diagnose diseases of the nervous system).
Radiologic technologists perform a wide range of duties, from greeting patients and putting them at ease by explaining the procedures to developing the finished film or preparing the video or digital image. Their administrative tasks include maintaining patients' records, recording equipment usage and maintenance, organizing work schedules, and managing a radiologist's private practice or hospital's radiology department. Some radiologic technologists teach in programs to educate other technologists.