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Radiology is a branch of medicine concerned with the use of radiant energy to diagnose and treat diseases. This field is divided into two major categories: diagnostic and interventional radiology. A radiologist is a physician who specializes in radiology.

The outcome of an imaging study is not solely dependent on the indication or the technical execution. Diagnostic radiology specialists are the final link in the diagnostic chain, searching for relevant image information to evaluate and support a proper diagnosis.

Radiology’s History
In 1895, Wilhelm Conrad Röntgen was working in a darkened laboratory in Würzburg, Germany, when he noticed a screen painted with a fluorescent material in the same room. Still, a few feet away from a cathode ray tube he had energized and made lightproof, it began to fluoresce.

Röntgen recognized that the screen was responding to the nearby production of unknown rays transmitted invisibly through the room, which he called “X-rays.” Radiographic images were created, beginning with a burst of ionizing radiation that produced a contrasting print on a film.
In 1901, Röntgen was awarded the first Nobel Prize in Physics for his discovery, and the public was captivated by the subsequent developments and implications. Nonetheless, early radiologists were unconcerned about the potential dangers of X-rays, and protective measures were not implemented until 1904, following the death of Clarence Dally (the long-time assistant of Thomas Edison in X-ray manufacture and testing).

Radiology procedures
Conventional radiographic images (usually shortened to X-rays) are produced by a combination of ionizing radiation (without added contrast materials such as barium or iodine) and light striking a photosensitive surface, which has a latent image that is then processed, similar to the pictures produced in 1895.

The main benefits of conventional radiography are the low cost of the images and the ability to obtain them virtually anywhere using mobile or portable machines (for example, mammography). The disadvantages are its limited range of densities and the use of ionizing radiation.

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The workhorse of radiology is currently computed tomography (CT). Recent advancements enable quick volume scans capable of producing two-dimensional slices in all possible orientations, as well as sophisticated three-dimensional reconstructions. Nonetheless, the radiation dose remains high, necessitating a strict indication for each planned CT.

Ultrasonography is still the most affordable and risk-free technology in radiology, which is why many physicians outside of radiology use it. Ultrasound probes generate images by utilizing acoustic energy above the audible frequency of humans. This modality is especially useful in imaging children and pregnant women because it does not use ionizing radiation.

Magnetic resonance imaging (MRI) uses the potential energy stored in the body’s hydrogen atoms. These atoms are manipulated by compelling magnetic fields and radiofrequency pulses to generate an adequate amount of localizing and tissue-specific energy, which is then used by highly sophisticated computer programs to create two-dimensional and three-dimensional images. The primary benefit is that no ionizing radiation is used.
Fluoroscopy is a modality in which X-rays are used to perform real-time visualization of the body, allowing for the evaluation of body parts, administration of contrast flow, and bone and joint positioning changes. Because many images are acquired for every minute of the procedure, radiation doses in fluoroscopy are significantly higher than in conventional radiography.

Nuclear medicine images are created by injecting the patient with a short-lived radioactive material and then recording the radiation emitted by the patient with a gamma camera or positron emission scanner. Single-photon emission computed tomography (SPECT) and positron emission tomography (PET) are the most commonly used nuclear medicine modalities in clinical practice (PET).

Finally, advances in equipment and computer power have enabled the combination of data imaging sets from various modalities in radiology; the most popular application of this has been the integration of PET functional nuclear medicine data with CT anatomic data (PET/CT), which is now widely used in cancer imaging.
Diagnostic Radiologists

Diagnostic radiologists use a variety of imaging procedures to see inside the body and assess or diagnose the patient’s condition. Your radiologist plays a vital role in your health by acting as an expert consultant to your referring physician (the doctor who sent you for testing) by assisting in choosing the proper exam and directing radiology technologists (those who operate the equipment) in properly performing quality exams. They interpret and report on the resulting images, recommending treatment and, only when appropriate, additional tests.

Diagnostic radiologists, through extensive clinical work and related research, may also specialize in these radiology subspecialties:

Breast imaging (mammograms) (mammograms)
Cardiovascular radiology (heart and circulatory system) (heart and circulatory system)
Chest radiology (heart and lungs) (heart and lungs)
Emergency radiology
Gastrointestinal radiology (stomach, intestines, and abdomen) (stomach, intestines, and abdomen)
Genitourinary radiology (reproductive and urinary systems) (reproductive and urinary systems)
Head and neck radiology
Musculoskeletal radiology (muscles and skeleton) (muscles and skeleton)
Neuroradiology (brain and nervous system; head, neck, and spine) (brain and nervous system; head, neck, and spine)
Pediatric radiology (imaging of children) (imaging of children)

Interventional Radiologists

These radiologists diagnose and treat patients using image-guided, minimally invasive techniques such as X-rays and MRIs. They carefully guide instruments through tiny incisions in the body, reaching the source of a medical problem and delivering targeted treatments. These treatments are for heart disease, stroke, cancer, and uterine fibroids, offering less risk, pain, and recovery time than traditional surgery.

Radiation Oncologists

These highly trained radiologists prescribe and oversee each cancer patient’s treatment plan. They use radiation therapy to treat cancer, and they monitor the patient’s progress and adjust treatment to make sure patients receive appropriate quality care. Radiation oncologists receive extensive training in cancer medicine, the safe use of radiation to treat disease and managing any side effects caused by radiation.
A former patient comes into the dental office and states that she has recently been diagnosed with skin cancer. She demands her x-rays and treatment record, and claims that she was exposed to unnecessary radiation during her visits. How should the dental assistant respond? Can the dental assistant be held responsible?

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