Post on 13-Dec-2015
CT & MRI – What is Expected from the Radiological Technologists
Dr. Harsha Dissanayake MBBS, M.Phil, MD(Radiology)Dip. Neurovascular Diseases (France)Consultant Radiologist & Senior Lecturer Faculty of Medical SciencesUniversity of Sri Jayewardenepura
Radiographer
Radiological Technologist
Medical Imaging Technologist
Who is a Radiological Technologist?
• a trained health care professional • who performs medical imaging by • producing high quality images which is useful
to diagnose and treat injury or disease. • patient’s diagnosis and treatment is often
dependent on the images produced.• He is an important member of the Health care
team.
Health Care Professional
• undertakes a specialized set of tasks• enjoys considerable work autonomy• engaged in creative and intellectually
challenging work• Patients place a great deal of trust in them• strict codes of conduct• Ethical and moral obligations
What should be the goal – when encountered with a patient
• To generate the best possible, • Highest quality,• Appropriate images – which will be used to arrive at the diagnosis /
or to treat.
How to achieve this goal ?• Asses the patient’s problem – get the
information• Analyze • Set the goal clear• Formulate a plan to achieve the goal• Workout the plan performing the tasks• Self evaluate your images – “Is this the best
possible images that I can generate?”
Quality control of the procedure• Inferior quality images / study – Area of interest inadequately covered / all
sequences not included ……….etc
May lead to– Inaccurate interpretation / wrong diagnosis– Repeated exposure – Radiation hazards to the patient / self / staff– Additional cost – Additional time
Competency ?• expertise and knowledge of patient handling• physics, anatomy, physiology and radiology to assess
patients• develop optimal radiologic techniques to plan and
evaluate – resulting radiographic images.• Should be able to spot “what is not normal” –
pathology • Radiation Protection • Quality Control
How the competency is gained?
• High school Diploma – Certificate course • University Degree BSc in Diagnostic
Radiography/Diagnostic Imaging – 3yrs • Can specialize in-house or through a university
course as a postgraduate in CT, MRI, Nuclear Medicine ….. with opportunities to gain an MSc in their field.
CT & MRI – What is Expected from the Radiological Technologists
• Before / During / After the procedure • Check the identity and the requested
investigation• Check the consent• explaining the procedure• ensure that the patent has had the correct
preparation• Keep the emergency tray ready
• clothing, ensure that there are no metal objects that may interfere
• Check the clinical details – if inadequate make a note of the patents problem & relevant details. Get previous imaging Ix reports/films
• If the requested investigation is not clear / inappropriate, always discuss with the referring clinician
• Check the patients data sheet / questionnaire – whether it is appropriately filled
• Are there any contraindications / Allergies?
During the scanning
• Radiation dose
• All medical radiation exposures must be justified and the radiation levels optimized
• Radiation to the patient (in diagnostic studies), staff and the general public are to be kept AAs LLow AAs RReasonably AAchievable (the ALARAALARA principle)
Protocols• Protocols are mere guidelines. • Has to modify according to the individual
patients problem – when ever necessary • Timing of the procedure• Whether to give contrast or not• Timing of the contrast injection • Arterial / venous / late phases• Oral /rectal contrast • MRI – additional sequences - ? Haemorrage /
Calcification / stroke ……..
Example 1
• 60yrs• Male• Haematuria
• Ix. – CT KUB
CT KUB – Normal / no calculi
• Are you happy?
Late finding
48 yrs / liver lesion in USS Ix. - Triple phase CTArterial Portal venous
Ix. - Triple phase CT
Arterial Portal venous
Ix. - Triple phase CT
Arterial Portal venous