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The life has become so colorful with signs of vitality but radiology deals
with the black and white of human's life. Radiology is the branch of medical
science dealing with the use of X-ray machine or other such radiation instruments
and it is also the science of precision and measurement. It uses electromagnet radiations
and ultrasound to the diagnoses and treatment of injury and disease. It is also the examination
of the inner structure of opaque objects using x-ray or other penetrating radiations. Two main
specialties are being practiced in radiology namely Diagnostic Radiology and Interventional
Radiology. Diagnostic radiology is concerned with the use of various imaging modalities to
aid in the diagnosis of disease whereas Interventional Radiology uses their imaging modalities
to guide minimally invasive surgical procedures.In radiotherapy we use radiations to treat disease
such as cancer. While originally encompassed within radiology, Therapeutic Radiology ---or, as it
is now called, Radiation Oncology----is now a separate field.
Diagnostic Radiology
Commonly used imaging modalities include plain Radiography, Computed Tomography (C.T.),
Magnetic Resonance Imaging (M.R.I.), Ultrasound Imaging and Mammography. Each of these
modalities has their own strengths and limitations, which dictate its use in diagnosis.
1. X-Rays
Radiographs are often used for quick evaluation of bony structures.
Fluoroscopy, Angiography and Barium Contrast studies are special
application of X-ray imaging, where as X-ray Video Camera allows the
imaging of structures in motion or augmented with a contrast agent.
Often, chemicals are injected, swallowed or otherwise administered
into the body of the patient to help delineate certain parts of the
body such as the blood vessels and gastrointestinal tract. These
contrast materials, which strongly absorb X-ray radiations, also
helps to demonstrate dynamic processes, such as the motion of the
digestive tract.
2. Computed Tomography Scanning
CT imaging uses X-rays in conjunction with computing algorithms to
image a variety of soft tissues in the body. X-ray contrast is often
used with C.T. as well. C.T. can generate much more detailed images
than plain X-rays, but exposes the patient to more ionizing radiations.
3. Ultrasound
Ultrasound imaging uses High-Frequency Sound Waves to visualize soft
tissue structures in the body in real time. No radiation is involved,
but the quality of the images obtained using ultrasound is highly
dependent on the skill of the person performing the exam.
4. Magnetic Resonance Imaging
MRI uses strong magnetic fields to align spinning atomic nuclei
(usually hydrogen protons) within body tissues, then disturbs the
axis of rotation of these nuclei and observes the radio frequency
signals generated as the nuclei return to their baseline states.
MRI scans give
the best tissue resolution of all the imaging
modalities. With advances in scanning speed and spatial
resolutions and improvements in computer 3D algorithms
and hardware. MRI may have the greatest potential for
development in the next few years.
5. Nuclear Medicine
Nuclear medicine imaging involves the administration into the patient
of substances labelled with radioactive tracers, which have affinity for
particular tissues. The heart, lungs, thyroid, liver, gallbladder and bones
are commonly evaluated for particular conditions using these techniques. While
anatomical detail is limited in these studies, nuclear medicine is useful in
displaying physiological function. Processes such as the growth of a tumor can
often be monitored this way, even when the tumor cannot be adequately visualized
using any of the other modalities.
Interventional Radiology
Interventional radiology is the non-surgical treatment of a growing
number of diseases using radiologic imaging to guide catheters (hollow, flexible tubes)
, balloons, filters, and other tiny instruments through the body's blood vessels and other
organs.Common interventional radiologic procedures includes: Balloon Angioplasty,
the use of a balloon to open blocked or narrowed arteries and place different kinds
of stents (For example; Drug Coated Stents & Simple Stents) which make the vessel patent.
Chemoembolization, the delivery of anticancer drugs directly to a tumor;
Fallopian Tube Catherization, which opens blocked fallopian tubes, a common cause
of infertility in women and Thrombolysis, which dissolves blood clots.
Mammography
Mammography is one of the most important modality in radiology as there is
increased risk of breast cancer throughout the world. Actually most of the
doctors advised women to do their own self-examination, which is not
sufficient only. Education of women is very important so that they should
know when, where to go and what to do in a proper way. Breast screening
is one of the important task that I would like to stress. There difficult
biases in severing which are: -
1. Lead time bias
2. Length bias
3. Class bias
Test Screening
We compute in absolute terms so that an individual woman can work out her
chances of benefit following a decade of mammographic severing.The risk
of a woman aged between 50-60 for developing breast cancer is 2/1000
per year, or 20/1000 over a decade. The anticipated 10 year survival
for clinically detected breast cancer in the absence of screening is
about 75 per cent. Therefore, we can expect five deaths form breast
cancer over this period. The relative risk reduction for screening
applies to these five women. From the above overview, a realistic
estimate would be the saving of one life (a relative risk reduction
of between 16-25 per cent). Therefore, one in a thousand women stand
to benefit from a decade of screening, while 999 have to undergo screening.
Doctors Hospital has well equipped radiology department providing all the facilities
with competent doctors including female radiologist and well-trained
radiographers. I personally do each of the required studies including
mammography.
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