Specialization in Radiologic Technology

CHAPTER 23


Specialization in Radiologic Technology




Outline



Radiation Therapy



Nuclear Medicine



Sonography



Special Procedures Radiography



Mammography


Computed Tomography



Magnetic Resonance Imaging



Bone Densitometry


Radiologist Assistant


Conclusion



Objectives


On completion of this chapter, you should be able to:


• Discuss the history of the several areas of specialization in radiologic technology.


• Describe the scope and practice of the specialized areas.


• List the requirements for entry into the specialty programs and qualifications for certification.


• Describe special equipment required for ultrasound, nuclear medicine, computed tomography, and magnetic resonance imaging.


• Describe the curriculum content specific to the areas of specialization.


• Compare images produced with ultrasound, computed tomography, and magnetic resonance imaging to images produced with radiation from the perspective of diagnostic quality.



Key terms



Diagnostic radiology has progressed significantly since its beginning in 1895. It began as a means of determining a patient’s illness by recording radiographic images on photographic film, identifying fractures, and examining internal organs for tumors or other physiologic disturbances. Today, however, diagnostic radiology encompasses much more than the simple procedures begun at the end of the nineteenth century (Box 23-1).



BOX 23-1   Radiologic Technologist or Diagnostic Medical Radiologic Technologist





Duties and Responsibilities



• Performs diagnostic radiographic procedures



• Corroborates patient’s clinical history with procedure; ensures that information is documented and available for use by a licensed practitioner


• Prepares patient for procedures; provides instructions to obtain desired results, gain cooperation, and minimize anxiety


• Selects and operates radiography equipment, imaging, and/or associated accessories to perform procedures successfully


• Positions patient to demonstrate best the anatomic area of interest while respecting patient ability and comfort


• Immobilizes patients as required for appropriate examination


• Determines radiographic technique exposure factors


• Applies principles of radiation protection to minimize exposure to patient, self, and others


• Evaluates radiographs or images for technical quality; ensures that proper identification is recorded


• Assumes responsibility for the provision of physical and psychologic services to patients during procedures


• Practices aseptic techniques as necessary


• Understands methods for and is capable of performing venipunctures


• In agreement with state statute(s) and/or where institutional policy permits, prepares, identifies, and/or administers contrast media and/or medications as prescribed by a licensed practitioner


• Verifies informed consent for and assists licensed practitioner with interventional procedures


• Assists licensed practitioner with fluoroscopic and specialized interventional radiography procedures


• Performs noninterpretive fluoroscopic procedures as appropriate and consistent with applicable state statutes (where applicable)


• Initiates basic life support when necessary


• Provides patient education


• Assists in maintaining records, thereby respecting confidentiality and established policy


• Assumes responsibility for assigned area; reports equipment malfunction


• Provides input for equipment purchases and supply decisions


• Provides practical instruction for students and/or other health care professionals


• Participates in the department’s quality assessment and improvement plan; may be responsible for specific quality control duties in assigned area


• May be responsible for control of inventory and purchase of supplies for assigned area


• Maintains knowledge of and observes universal precautions


• Understands and applies patient-relation skills


• Pursues appropriate continuing education



The American Society of Radiologic Technologists (ASRT) Job Description and Scope of Practice reflects the expanded role of today’s radiologic technologist.


The role of the radiologic technologist has increased in complexity and responsibility since its rather simple early beginnings. In addition to developments within diagnostic radiography, specialized areas have evolved for the diagnosis and treatment of disease. These areas, which provide many opportunities for today’s radiologic technologists, include special procedures radiography, mammography, computed tomography, magnetic resonance imaging, nuclear medicine, radiation therapy, and sonography.



Radiation therapy



History


Radiation therapy, which is called radiation oncology, began approximately a year after x-rays were discovered in 1895. A medical student, Emil H. Grubbe, together with a physician friend, treated an advanced case of breast cancer with x-rays in 1896. Grubbe continued his research for many years but eventually contracted skin cancer and lost his left hand. Neither radiation nor its potential dangers were yet understood. Rather, radiation was thought to be a cure-all. After discovering that radiation produced epilation (loss of hair), the suggestion was made that shaving would no longer be necessary. Radiation was also used to cure blindness, epilepsy, acne, and warts, as well as various bacterial and viral infections. Almost every form of malignant and benign disease was treated. Because so little was known about the effects of radiation, the results were disappointing. The damaging effects of radiation were realized as the number of injuries was brought to public attention. Some people even demanded that the use of radiation be abandoned altogether, but techniques and equipment improved, with a moderate number of good results.


In 1904, Bergonie and Tribondeau announced their landmark findings about tissue response to radiation. They discovered that, at certain times, living cells are more sensitive to the effects of radiation.


Unlike the other specializations in radiology, radiation therapy is not used to diagnose disease. Therapy involves treating a patient who is already known to have a disease. Radiation therapy is practiced by exposing a diseased area to various types of radiation while also trying to protect the unaffected parts of the patient’s body from radiation exposure. Most of the diseases treated with radiation today are cancerous. In the past, nonmalignant diseases were successfully treated with radiation; but today other forms of therapy are preferable for most noncancerous conditions.



Responsibilities of the Radiation Therapist


The radiation therapist applies ionizing radiation to the patient in accordance with the prescription and instructions of the radiation oncologist. The radiation therapist checks the physician’s prescription for mathematic errors. Accurate technical details of treatment administered must be recorded at the time of treatment. The patient must be properly positioned, and the area of interest must be correctly marked. In addition, the radiation therapist assists in the calibration of equipment and must be able to detect malfunctions and maintain control if a radiation accident occurs. The radiation therapist may be required to prepare molds and casts of various body parts, and he or she must understand the use of wedge and compensating filters for treatment. An understanding of minor surgical procedures and aseptic technique may also be required.


Finally, the radiation therapist must render care and comfort to the patient. Unlike diagnostic radiography, in which the radiologic technologist has brief contact with patients, patients undergoing radiation therapy are seen on a regular basis. Because of the traumatic emotional aspects that may be associated with a patient who is undergoing treatment for a malignancy, the radiation therapist must be empathetic to patients’ needs and refer them, when necessary, to social services.



Education and Certification


An individual who wishes to become a certified radiation therapist must attend a radiation therapy program approved by the Joint Review Committee on Education in Radiologic Technology (JRCERT) or its equivalent. Therapy programs are generally 1 year in length or 1 to 2 years in conjunction with a baccalaureate degree and may be established in community colleges, universities, hospitals, or clinics. Applicants may have prior qualifications from a clinically related allied health profession with a minimum of 2 years of education from an accredited educational program. The therapy curriculum generally includes courses in medical ethics and law, patient care, human structure and function, oncologic pathology, radiobiology, radiation physics and protection, clinical dosimetry, and computer applications. In addition to classes, the student spends time in the clinical environment learning a suitable variety and quantity of patient treatments.


At the successful completion of the educational program, a student is eligible to take the certification examination offered by the American Registry of Radiologic Technologists (ARRT). On successful completion of the examination, a certified radiation therapist is qualified to work in any major cancer treatment center or in large hospitals that have both diagnostic equipment and high-energy radiation therapy units. Individual state licensure may also be required.


A certified technologist may also wish to pursue additional training in medical dosimetry. A dosimetrist plans patient treatments and analyzes the radiation distribution and dose for accuracy and safety. Additional training can be up to 2 years of academics and 1 year of supervised work experience under a certified medical dosimetrist or certified medical physicist before examination by the Medical Dosimetrist Certification Board (MDCB).



Employment Opportunities


Opportunities for employment are available throughout the country. Positions are generally found in larger clinics or medical centers. Salaries vary according to location, employer, education, and work experience.


The ASRT Job Description and Scope of Practice for radiation therapists differs distinctly from that for the radiologic technologist. The description clearly indicates the difference in the body of knowledge required to develop the necessary skills for therapeutic techniques (Box 23-2).



BOX 23-2   Radiation Therapist RT(T)(ARRT)



Scope of Practice


The curriculum base for a Radiation Therapist is outlined in the ASRT Professional Curriculum for Radiation Therapy Technology. Education program standards are those defined in the Essentials and Guidelines of an Accredited Educational Program for the Radiation Therapy Technologist. Radiation therapy technology professional educational programs prepare the radiation therapist to, but are not limited to, the following:





Administering and Monitoring Radiation Therapy Treatments



• Implements a planned course of treatment


• Administers treatment accurately and safely; reports untoward effects, reactions, therapeutic responses, and incompatibilities


• Withholds treatment when conditions warrant, and consults with a radiation oncologist before proceeding


• Participates in total quality management system to ensure safe and accurate patient care


• Detects equipment malfunctions and takes appropriate action


• Accurately documents details of treatment procedures, and maintains daily treatment records


• Always applies principles of radiation protection


• Takes appropriate action with regard to real or potential radiation hazards


• Understands the function of equipment, accessories, treatment methods, and protocols, and applies such knowledge appropriately


• Simulates and plans a course of treatment by defining and identifying tumor volume, target volume, and treatment volume as directed and prescribed by the radiation oncologist


• Constructs and/or prepares immobilization devices, beam directional devices, and similar devices, which facilitates treatment delivery


• Performs daily and periodic quality assurance checks and related tasks as appropriate


• Performs dosimetric calculations and treatment planning procedures


• Monitors doses to normal tissues within the irradiated volume to ensure that tolerance levels are not exceeded


• Prepares and/or assists in the preparation and use of brachytherapy sources



Caregiving



ASRT, American Society of Radiologic Technologists.


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Mar 2, 2016 | Posted by in GENERAL RADIOLOGY | Comments Off on Specialization in Radiologic Technology

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