CT

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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 Sciences
• University of Sri Jayewardenepura

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Radiographer Radiological TechnologistMedical
Imaging Technologist
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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.
• patients diagnosis and treatment is often
  dependent on the images produced.
• He is an important member of the Health care team.

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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

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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.

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How to achieve this goal ?

• Asses the patients 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?

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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

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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

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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.

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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

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• 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?

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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 As
  Low As Reasonably Achievable (the ALARA
  principle)

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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 ..

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Example 1

• 60yrs
• Male
• Haematuria
• Ix. CT KUB

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CT KUB Normal / no calculi
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• Are you happy?

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Late finding
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48 yrs / liver lesion in USS Ix. - Triple
phase CT

• Arterial

• Portal venous

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Ix. - Triple phase CT

• Arterial

• Portal venous

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Ix. - Triple phase CT

• Arterial

• Portal venous

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