diagnostic radiology medical imaging

 

Diagnostic radiology plays a major role in streamlining many types of medical diagnoses. It can prevent unnecessary surgical intervention and speed treatment in emergencies. Types of diagnostic radiology include:

• X-rays
• Ultrasound
• Computed tomography (CT)
• Magnetic resonance imaging (MRI)
• Fluoroscopy
• Positron emission tomography (PET)

In both emergency and non-emergency situations, diagnostic radiology saves lives by providing physicians with information they need to make the most accurate diagnoses, create an informed plan of treatment, and provide follow-up studies.

Diagnostic Radiology During Community Events and Mass Casualty Situations

Community events like festivals, concerts, and sporting events can place extra stress on local healthcare systems. From establishing on-site medical tents to providing extra staffing at local hospitals and emergency rooms, medical teams must be prepared for more patients than usual, and for emergencies that require fast action.

In 2013, the Boston Marathon bombing required an enhanced response from Brigham and Women’s Hospital emergency department, which saw an extra 40 patients in need of emergency care. Of these, the vast majority (78%) required diagnostic imaging, mostly x-rays and CT scans. During the crisis, additional staff was mobilized, including radiologists, radiology fellows, residents, and radiological technologists. Additional imaging machines, including two CT scanners and portable x-ray units were brought in from elsewhere in the hospital. Despite the severity of the emergency, CT exam turnaround time dropped to just over half the median of 72 minutes experienced under routine operations, and “things went smoothly in terms of patient care,” according to Aaron Sodickson, MD, Brigham and Women’s Hospital emergency radiology director.

Emergency Departments and Diagnostic Radiology

Use of CT and MRI testing in emergency departments increased significantly from 2001 to 2010, with orders for and provision of those diagnostic radiology tests nearly tripling, from 6% to 17%. The number of emergency visits in which an ultrasound study was ordered or provided doubled, from 2% to 4%. Though the number of x-ray studies ordered or provided did not change significantly during that time period, around 35% of all emergency department visits involved the ordering or provision of x-rays.

Various types of diagnostic radiology are used in hospital emergency departments. For example, trauma, the leading cause of death in people younger than 45, is often the reason for medical imaging in emergency departments. Particularly with head trauma, CT and MRI are widely used. Another major indication for use of diagnostic radiology in emergency situations is suspected stroke, which is the third leading cause of death in the United States. Rapid evaluation and neuroimaging is the standard of care for those with suspected strokes, and is used in diagnosis as well as administration of thrombolytics. And medical imaging is often appropriate in emergency departments when appendicitis is suspected, with CT of the abdomen and pelvis, with use of intravenous contrast used most often.

Increasing Importance of Coronary CT Angiography (CCTA)

Coronary CT angiography, or CCTA, is starting to be used more in the diagnosis and management of coronary disease. A new generation of technology is expected to be of great use in an aging population, particularly in people with asymptomatic heart disease. People with diabetes, and those with siblings with premature heart disease are other possible candidates for this type of diagnostic imaging. Additionally, the number of patients for whom CCTA is deemed appropriate is increasing as technological advancements proceed, partly because CCTA allows better resolution for patients with faster heart rates and arrhythmias.

Another benefit of CCTA is that in a population with intermediate risk for an acute coronary event, the test found extra-cardiac anomalies in 11% of patients. These anomalies may not have been picked up by other diagnostic methods. Cardiac patients scheduled for aortic valve replacement and ablations are also increasingly being referred for CCTA as part of pre-op, because the test is believed to be a strong predictor of future coronary problems. Though CCTA won’t replace angiography, particularly among those at high risk for coronary events, it appears to be well suited for patients who are at intermediate risk for heart disease.

Diagnostic Radiology and In-Hospital Emergencies

Emergencies requiring the use of diagnostic radiology may occur during types of hospital care other than emergency department care. For example, obstetrical hemorrhage, which is the most significant cause of maternal death globally, is an emergency that can happen without warning, and diagnostic radiology can play an important role in saving these patients’ lives.

One case of diagnostic radiology in an obstetrical hemorrhage situation occurred in Coral Springs Medical Center in Florida, when a woman presented with uncontrollable hemorrhage during surgery. Multiple surgical maneuvers, ultimately including a hysterectomy, were unable to control bleeding. David H. Ring, Jr., of North Broward Radiology in Fort Lauderdale, who specializes in vascular and interventional radiology, was able to perform an intraoperative pelvic angiogram using a C-arm fluoroscopy unit, which was able to locate the source of bleeding so embolization could be performed, ultimately controlling the bleeding. The patient recovered from what could have been a lethal hemorrhage due to interventional diagnostic radiology.

Diagnostic Radiology and Diagnosis of Lung Cancer

New software techniques used along with CT scans are currently being developed that could eventually give radiologists a promising tool for measuring the growth of nodules in patients at risk of developing lung cancer. Researchers at Rochester Institute of Technology and the University of Pittsburgh Medical Center are developing algorithms to quantify nodule growth imaged on CT scans over a period of two years.

Comparing CT scans from different times can be complex, due to slight differences in patient positioning, and factors like patient weight gain. But the new algorithms under development should be able to compensate for many factors that make CT scan comparison difficult. The rate at which nodules grow can indicate whether a nodule is likely benign, caused by an infection, or malignant. Researchers hope that the algorithms allow for more accurate estimates of nodule growth, which can help physicians in their determination of further diagnostic procedures, potentially providing another method by which diagnostic radiology can help save lives.

SteleRAD has over 40-years experience providing expert diagnostic and interventional radiological services in level I and level II trauma centers.

SteleRAD is based in South Florida and is owned and operated by Board-certified radiologists. Our team of highly experienced radiologists with expertise in a broad range of radiology subspecialties is ready to serve the diagnostic imaging needs of hospitals, practices, and imaging centers. Having uninterrupted access to critical radiology services can be essential to the most positive patient outcomes, and SteleRAD has provided a range of radiology services for over 40 years. To learn more about SteleRAD’s services, subspecialties, and physicians, contact us online or call 954-358-5250.