Computed Tomography, MRI, Mammography, Ultrasound, and regular x-rays are all different diagnostic exams that fall under the branch of Radiology. During this experience, I will work with The Pink Monarch, operated by Dr. Marseea Howard, and experience what it is like to handle serious situations such as the ones presented in this field. I became interested in this topic when I became very sick, and the doctor believed that my kidney might have ruptured, so they performed an ultrasound on my stomach.
I was fascinated with the vivid, colorful, and detailed images that popped up on the screen. What do all those colors mean? How does such a little lense see past my flesh and inside my body? How will this test help the doctor to make a diagnosis? How does this machine work? What type education and training does it require to become proficient in this field? Is the person using the technology in in danger? What all diseases and conditions can be diagnosed and treated with this technology? Who discovered this technology, and who invented the machines? How much does it cost to purchase the equipment, and how much does a procedure cost the patient? The more I thought about the technology, the more questions I had about it.
I am fortunate enough to have close ties with someone whose family owns a radiology center. I contacted them regarding the possibility of an internship to explore my questions, and to gain valuable insight into a field I am considering pursuing for my future.
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Dr. Howard operates the premier radiology center in Columbus, Georgia, and has technology not available anywhere else in the southeast. She has extensive education, having degrees in aeronautics, veterinary medicine, and human medicine. She is eager to share her knowledge with her patients, and with the public. Even though her office had never participated in an internship, she immediately agreed to my request. To ready myself to begin my experience, I researched protocol in working inside a doctor’s office. Discretion, professionalism, compassion, and privacy were some of the words that kept cropping up during my research. Also, I researched the discovery and history of the x-ray, and how it has expanded since it was discovered. I felt that knowing something about how a physician’s office is operated, and the services provided to their patients, would better prepare me for my experience. It would also show Dr. Howard I was serious about my experience, and now just attempting to fill a requirement for graduation.
I was also curious as to how patients who come to Dr. Howard’s office are feeling about the procedures they will undergo. Is everyone who comes to her office ill? Do they have conditions which are easily treated, or do they have life threatening conditions which might lead to their eventual death? Do the procedures they undergo cure them, or are they strictly used as a diagnostic tool? Are the patients apprehensive about the procedures? How does the staff, the technicians and the physicians make the patient feel more at ease? What degrees do the people at the office have? Where can someone get these degrees, and what are the criteria to be accepted at those institutions? I am considering working in this field, and wondered how long I would be in school?
I chose this experience because I am interested in the technology, and I am considering this area for my eventual career. I have a wonderful contact through Dr Howard, and her family, and being able to actually work in an office that deals with radiological treatment and diagnosis equipment will give me insight into how the technology works and how it is used to help patients. It will allow me to gather the needed information to make a thoughtful, and serious decision, it this is the field I eventually want to work in as my profession. I also hope this experience will allow me a better look into how patients feel when they undergo treatment in this type facility. It will allow my sense of empathy for patients who might be feeling anxiety, and give me tools to help alleviate their fears.
After working with, and observing my mentor, I expect to have a clearer understanding regarding radiology, how it is administered, how it is used to diagnose and treat, and how to make patients less anxious when seeking out this treatment. These points are realistic goals for my internship, and not only will they benefit me as a person and as an educational experience, they will allow me to determine if this is a credible career path for my future. The birth of Radiology began in the late 1800’s, when a German professor discovered X-Rays (Howard). Whilheim Conrad Roentgen used his wife in his experiments, eventually winning a Nobel Peace Prize for his work. X-Rays were initially used not in the medical field but, to try to detect submarines. The first medical ultrasounds,or the Piezoelectric Effect, were first explored by Jacques and Pierre Curie, and were useful in transducers to generate and detect waves in air and water (History of Radiology). While the beginnings of Radiology started in the late 19th century, making it a relatively new medical field, major advances have occurred which have lead us to the current technology now used to help diagnose and treat diseases and conditions.
The cost of imaging equipment is prohibitive, and probably second only to the actual building cost of a hospital. A 3D digital mammography unit cost approximately 450,000 dollars and a 3-D ultrasound cost about 300,000 dollars you also have to have a workstation, with the ability to process huge amounts of imaging, at a cost of 250,000 dollars (Howard). Most Radiology centers have several pieces of each imaging equipment, constituting a huge part of the capital budget. These investments are recouped through the cost of procedures charged to the patients. Procedure costs vary, depending on what type of imaging is being used, but maybe reduced by the patient’s insurance, and/or Governmental payouts.
Professionals in radiology are in high demand, being the third largest group of healthcare professionals following only doctors and nurses (Institute of Carrer Research). Radiologist and Sonographers are highly trained in three dimensional human anatomy. This knowledge guides them in both operating the equipment, and being able to read the results of the imaging. Ultrasonography is an imaging technique that uses high frequency sound waves and their echos (Howard). The ultrasound waves are produced by a transducer which can produce waves as well as detect reflected echos. These tests use a grayscale to record frequencies, with the more difficult areas to penetrate showing white, while the less dense areas record as black leading to the Color Doppler which was a breakthrough in medical ultrasound technology those untrained in radiology can relate this type of imaging to what they would see when viewing a Weather Doppler (Howard). The colors on an ultrasound indicate flow and strength of flow which can be both arterial, venous, or both. Colors can also reveal what type masses are being indicated, and may give surgeons an idea on how to approach and remove a tumor. Color Doppler is most advantageous when used to evaluate conditions of the heart.
Ultrasound transducers, the handheld devices, are made of special ceramic crystal materials called piezoelectrics. Piezoelectricity is the electrical charge that accumulates in certain solid materials when mechanical stress is applied (Howard). The word Piezoelectricity comes from the Greek word piezein, which means to squeeze or press and the word piezo which means to push. The materials in the transducers can produce sound waves under the pressure of an electric field, but can also work in reverse by producing an electric field when a sound wave hits them. These sound waves are reflected back to the transducers by the boundaries between fluid,soft tissue, tissue, or bone. The Radiologist uses this information, along with their expertise in 3D anatomy, to produce a non-invasive review of what is going on inside the body.
Most diseases can be imaged by some form of imaging. Radiography technology was first used to diagnose breast abnormalities in the 1920’s but were not refined until the late 1960’s (Sergant). Breast centers, such as the Pink Monarch, are geared specifically to locate and diagnose breast cancer. These types of centers are critical because more than 40,000 deaths in the United States a year are attributed to breast cancer. With over 265,000 cancer diagnosis per year, prevention and early detection are critical when treating diseases of the breast. Along with Ultrasound, other imaging modalities such as Diagnostic Imaging, MRI, and CT scans, give comprehensive information to the comprehensive medical team treating the patient. One of the largest advantages of Ultrasound technology is that it is not based on the X-Ray.
Most breast care centers are generally walk in, with the function of screening and diagnosing breast cancer. They also operate as a long term follow up in post diagnosis in cases of recurrences. Most people who come to a breast care center are not ill. Many come for preventative care, or as a result of finding a lump or knot in their breast. Some conditions such as fibrocystic disease are diagnosed in breast centers and are relatively harmless. However, some patients will receive a diagnosis of cancer. Thankfully, imaging technology has made great strides in improving the odds that patients diagnosed with cancer have a much greater survival rate than in the past. Early detection is crucial in saving lives, and radiological medicine is the first step to the cure.
Many patients are apprehensive about visiting centers of Radiology. Some of this apprehension is due to uncertainty of what type test will be performed, nervousness over any possible condition that could be detected, or fear of being exposed to radiation. Radiology departments are highly regulated at both the state and federal levels. Mandatory compliance to regulation is checked by annually through unannounced inspections. Extreme care is taken to protect both patients and healthcare workers. Healthcare workers are at no greater risk of exposure than the general population when compliance is carefully attended to. Patients can be calmed by a well trained staff, compassionate technologist, and speedy and accurate test results. Patients can also have their anxiety lessened by realizing that most detected tumors turn out to be benign.
Typically there are two career paths when dealing with the field of Radiology. A Sonographer can not read exams, but under careful guidance of a Radiologist they can administer and perform radiological tests. A Sonographer can receive their training by applying and attending an approved ultrasound school or attending an accredited radiology technology institution. They would first become a registered radiology technologist, then they might perceded to an ultrasound school to specialize. A radiologist is a medical doctor, and they will spend four years in pre-med, followed by four years of medical school, four years of radiology residency, and then one to two years in a sub-specialization field of radiology. This might be the field of breast, neurological radiology, or some other specialized area of radiological medicine.
Works Cited
- “History of Radiology.” Radiology CME Conferences in 2018 & 2019 by CME Science (7 Course Destinations), 28 Dec. 2017, cmescience.com/history-of-radiology/.
- Howard, Curtis.Mentor Interview Senior Project.1/8/19.
- Institute for Career Research. Career As a Radiologic Technologist : Third Largest Group of Healthcare Professionals (Following Physicians and Nurses). Institute for Career Research, 2010. EBSCOhost, proxygsu-smus.galileo.usg.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=309717&site=eds-live&scope=site.
- Oweida, Ayman, B.Sc. .. M.Sc. “Radiology and Medical Imaging.” Salem Press Encyclopedia of Science, 2018. EBSCOhost, proxygsu-dep1.galileo.usg.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ers&AN=89250568&site=eds-live&scope=site.
- Sergent, Breanne. “Disclosing the Gray Areas of Mammography: Should Women with Dense Breast Tissue Remain in the Dark About Breast Cancer Screening Alternatives?” Journal of Legal Medicine, vol. 34, no. 4, Oct. 2013, pp. 453–482. EBSCOhost, doi:10.1080/01947648.2013.859973.
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