Perhaps the most familiar use of the x ray is the diagnosis of broken bones. However, medical uses of radiation go far beyond that. Radiation is used not only to produce images of the interior of the body, but to treat cancer as well. At the same time, the use of imaging techniques that do not involve x rays, such as ultrasound and magnetic resonance scans, is growing rapidly. The term diagnostic imaging embraces these procedures as well as the familiar x ray.
Radiographers produce x-ray films (radiographs) of parts of the human body for use in diagnosing medical problems. They prepare patients for radiologic examinations by explaining the procedure, removing articles such as jewelry, through which x rays cannot pass, and positioning patients so that the correct parts of the body can be radiographed. To prevent unnecessary radiation exposure, technologists surround the exposed area with radiation protection devices, such as lead shields, or limit the size of the x-ray beam. Radiographers position radiographic equipment at the correct angle and height over the appropriate area of a patient's body. Using instruments similar to a measuring tape, technologists may measure the thickness of the section to be radiographed and set controls on the machine to produce radiographs of the appropriate density, detail, and contrast. They place the x-ray film under the part of the patient's body to be examined and make the exposure. They then remove the film and develop it.
Experienced radiographers may perform more complex imaging tests. For fluoroscopies, radiographers prepare a solution of contrast medium for the patient to drink, allowing the radiologist, a physician who interprets x rays, to see soft tissues in the body. Some radiographers operate computed tomography scanners to produce cross-sectional views of patients and may be called CT technologists. Others operate machines using giant magnets and radiowaves rather than radiation to create an image and may be called magnetic resonance imaging (MRI) technologists.
Radiation therapy technologists, also known as radiation therapists, prepare cancer patients for treatment and administer prescribed doses of ionizing radiation to specific body parts. They operate many kinds of equipment, including high-energy linear accelerators with electron capabilities. They position patients under the equipment with absolute accuracy in order to expose affected body parts to treatment while protecting the rest of the body from radiation.
They also check the patients reactions for radiation side effects such as nausea, hair loss, and skin irritation. They give instructions and explanations to patients who are likely to be very ill and may be dying. Radiation therapists, in contrast to other radiologic technologists, are likely to see the same patient a number of times during the course of treatment.
Sonographers, also known as ultrasound technologists, use non-ionizing, high frequency sound waves into areas of the patient's body; the equipment then collects reflected echoes to form an image. The image is viewed on a screen and may be recorded on a printout strip or photographed for interpretation and diagnosis by physicians. Sonographers explain the procedure, record additional medical history, and then position the patient for testing. Viewing the screen as the scan takes place, sonographers look for subtle differences between healthy and pathological areas, and judge if the images are satisfactory for diagnostic purposes. Sonographers may specialize in neurosonography (the brain), vascular (blood flows), echocardiography (the heart), abdominal (the liver, kidneys, spleen, and pancreas), obstetrics/gynecology (the female reproductive system), and ophthalmology (the eye).
Radiologic technologists follow precisely physicians' instructions and regulations concerning use of radiation to insure that they, patients, and co-workers are protected from over exposure.
In addition to preparing patients and operating equipment, radiologic technologists keep patient records and adjust and maintain equipment. They may also prepare work schedules, evaluate equipment purchases, or manage a radiology department.
Radiologic technologists may be on their feet for extended periods of time.
Most full-time radiologic technologists work about 40 hours a week; they may have evening and weekend or on-call hours.
Technologists are on their feet for long periods and may lift or turn disabled patients. They work at radiologic machines but may also do some procedures at patients bedsides. Some radiologic technologists travel to patients in large vans equipped with sophisticated diagnostic equipment.
Radiation therapists are prone to emotional burn out since they regularly treat extremely ill and dying patients on a daily basis. Although potential radiation hazards exist in this occupation, they have been minimized by the use of lead aprons, gloves, and other shielding devices, as well as by instruments that measure radiation exposure. Technologists wear badges that measure radiation levels in the radiation area, and detailed records are kept on their cumulative lifetime dose.
Radiologic technologists held about 162,000 jobs in 1992. Most technologists were radiographers. Some were sonographers and radiation therapists. About 1 radiologic technologist in 5 worked part-time.
About 3 out of 5 jobs are in hospitals. The rest are in physicians' offices and clinics, including diagnostic imaging centers.
Preparation for this profession is offered in hospitals, colleges and universities, vocational-technical institutes, and the Armed Forces. Hospitals, which employ most radiologic technologists, prefer to hire those with formal training.
Formal training is offered in radiography, radiation therapy, and diagnostic medical sonography (ultrasound). Programs range in length from 1 to 4 years and lead to a certificate, associate degree, or bachelor's degree. Two-year programs are most prevalent.
Some 1-year certificate programs are for individuals from other health occupations such as medical technologists and registered nurses who want to change fields or experienced radiographers who want to specialize in radiation therapy technology or sonography. A bachelor's or master's degree in one of the radiologic technologies is desirable for supervisory, administrative, or teaching positions.
The Committee on Allied Health Education and Accreditation (CAHEA) accredits most formal training programs for this field. CAHEA accredited 687 radiography programs, 120 radiation therapy programs, and 52 diagnostic medical sonography programs in 1992.
Radiography programs require, at a minimum, a high school diploma or the equivalent. High school courses in mathematics, physics, chemistry, and biology are helpful. The programs provide both classroom and clinical instruction in anatomy and physiology, patient care procedures, radiation physics, radiation protection, principles of imaging, medical terminology, positioning of patients, medical ethics, radiobiology, and pathology.
For training programs in radiation therapy and diagnostic medical sonography, applicants with a background in science, or experience in one of the health professions, generally are preferred. Some programs consider applicants with liberal arts backgrounds, however, as well as high school graduates with courses in math and science.
Radiographers and radiation therapists are covered by provisions of the Consumer-Patient Radiation Health and Safety Act of 1981, which aims to protect the public from the hazards of unnecessary exposure to medical and dental radiation by ensuring operators of radiologic equipment are properly trained. The act requires the Federal Government to set standards that the States, in turn, may use for accrediting training programs and certifying individuals who engage in medical or dental radiography.
By 1992, 26 States required radiographers to be licensed, and 23 required radiation therapists to be licensed. (Puerto Rico requires a license for the practice of either specialty.) One State, Utah, licenses diagnostic medical sonographers.
Voluntary registration is offered by the American Registry of Radiologic Technologists (ARRT) in both radiography and radiation therapy. The American Registry of Diagnostic Medical Sonographers (ARDMS) certifies the competence of sonographers. To become registered, technologists must be graduates of a CAHEA-accredited program or meet other prerequisites and have passed an examination. Many employers prefer to hire registered technologists.
With experience and additional training, staff technologists may become specialists, performing CT scanning, ultrasound, angiography, and magnetic resonance imaging. Experienced technologists may also be promoted to supervisor, chief radiologic technologist, and ultimately department administrator or director. Depending on the institution, courses or a master's degree in business or health administration may be necessary for the director's position. Some technologists progress by becoming instructors or directors in radiologic technology programs; others take jobs as sales representatives or instructors with equipment manufacturers.
With additional education, available at major cancer centers, radiation therapy technologists can specialize as medical radiation dosimetrists. Dosimetrists work with health physicists and oncologists (physicians who specialize in the study and treatment of tumors) to develop treatment plans.
Employment radiologic technologists is expected to grow much faster than the average for all occupations through 2005, as the health care industries grow, and because of the vast clinical potential of diagnostic imaging and therapeutic technology. Current as well as new uses of imaging equipment are virtually certain to sharply increase demand for radiologic technologists.
Technology will continue to evolve. New generations of diagnostic imaging equipment are expected to give even better information to physicians and be used more widely. Since ultrasound is non-invasive, it is also less risky and uncomfortable for the patient than exploratory surgery.
Radiation therapy will continue to be used alone or in combination with surgery or chemotherapy to treat cancer. More treatment of cancer is anticipated due to the aging of the population, educational efforts aimed at early detection, and improved ability to detect malignancies through radiologic procedures such as mammography.
Although physicians are enthusiastic about the clinical benefits of new technologies, the extent to which they are adopted depends largely on cost and reimbursement considerations. Some promising new technologies may not come into widespread use because they are too expensive and third-party payers may not be willing to pay for their use. But on the whole, it appears that radiologic procedures will be used more widely.
Hospitals will remain the principal employer of radiologic technologists. However, employment is expected to grow most rapidly in offices and clinics of physicians, including diagnostic imaging centers. Health facilities such as these are expected to grow very rapidly through 2005 due to the strong shift toward outpatient care, encouraged by third-party payers and made possible by technological advances that permit more procedures to be performed outside the hospital. Some jobs will also come from the need to replace technologists who leave the occupation.
In 1992, the median annual earnings for radiologic technologists who worked year round full time were $28,236. The middle 50 percent earned between $22,932 and $33,748 a week; 10 percent earned less than $19,708 a week; and 10 percent earned more than $40,456.
According to a University of Texas Medical Branch national survey of hospitals and medical centers, the median annual salary for radiation technologists, based on a 40 hour week and excluding shift or area differentials, was $25,615 in October 1992. The average minimum salary was $22,250 and the average maximum was $32,553. For radiation therapy technologists the median was $34,278 and for ultrasound technologists, $32,219.
Radiologic technologists operate sophisticated equipment to help physicians, dentists, and other health practitioners diagnose and treat patients. Workers in related occupations include nuclear medicine technologists, cardiovascular technologists and technicians, perfusionists, respiratory therapists, clinical laboratory technologists, and electroencephalographic technologists.
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Reprinted with Permission of U. S. Department of Labor