Image-guided treatment for liver cancer

Patients with early-stage hepatocellular carcinoma (HCC) usually have no symptoms, so the disease is often advanced by the time it is diagnosed. HCC is resistant to chemotherapy, and the effectiveness of external beam radiation in treating the disease is limited. Surgical resection and liver transplantation offer a potential for cure. However, most patients have unresectable disease. This article discusses the less invasive image-guided ablative and embolization therapies that offer patients palliation of symptoms as well as the potential for increased survival. Radiologic technologists need to know the techniques of these procedures as well as normal and variant anatomy in patients and how those factors affect the delivery of therapeutic agents. This article is a Directed Reading. Your access to Directed Reading quizzes for continuing education credit is determined by your area of interest. For access to other quizzes, go to www.asrt.org/store.     

Medical imaging's role in bariatric surgery

Approximately 72 million Americans, or one third of U.S. adults, are obese. Bariatric surgery, the use of surgical procedures to alter the digestive tract, is the only treatment that results in major, long-term weight loss; it also can resolve obesity-related diseases. Its use has increased markedly in the past decade, and radiographic imaging plays an important role in assessing patients before surgery, along with identifying complications after surgery. The modalities used most frequently are ultrasound, gastrointestinal contrast studies, computed tomography and fluoroscopy. Radiologic technologists must be prepared for the technical, equipment and occupational safety challenges faced by imaging obese patients. This article is a Directed Reading. Your access to Directed Reading quizzes for continuing education credit is determined by your continuing education preference. For access to other quizzes, go to www.asrt.org/store.     

Domestic violence

Domestic violence is a neglected epidemic in the United States that affects millions of children and adults and leads to a sizable proportion of emergency department visits--and possibly the majority of nonfatal injuries among women. Health care encounters represent the most promising opportunities for identifying victims and intervening in patterns of abuse, and all health care professionals have an ethical obligation to help identify cases of abuse. In this Directed Reading, the epidemiology and outcomes of domestic violence are introduced, screening methods and reporting requirements are reviewed, and the roles of diagnostic imaging in detecting and characterizing frequently neglected but common domestic violence injuries are discussed. This article is a Directed Reading. Your access to Directed Reading quizzes for continuing education credit is determined by your area of interest. For access to other quizzes, go to www.asrt.org/store.     

Sarcoidosis: a primer

Sarcoidosis is an enigmatic disease with high variability in its manifestation within the body. Associated granulomas can form in many different parts of the body and can affect multiple organs. Some patients affected by this multiorgan disease never require treatment, while others require comprehensive long-term care and follow-up. Familiarity with the clinical and radiologic features of sarcoidosis is key to understanding how physicians diagnose and manage the disease. Further research is needed to comprehend the relationship between sarcoidosis and malignant neoplasms. This article is a Directed Reading. Your access to Directed Reading quizzes for continuing education credit is determined by your area of interest. For access to other quizzes, go to www.asrt.org/store.     

Imaging in podiatry

This article examines the vulnerability of the foot to injury and disease and the role imaging plays in ferreting out the causes of pain and dysfunction. The discussion includes a broad overview of foot disorders and describes the expanding role played by imaging in the diagnosis and management of foot disorders. This article is a Directed Reading. Your access to Directed Reading quizzes for continuing education credit is determined by your area of interest. For access to other quizzes, go to www.asrt.org/store.     

Diagnosis and treatment of scaphoid fractures

The scaphoid bone in the wrist is the most frequently fractured carpal bone. This Directed Reading discusses types of scaphoid fractures, issues of special concern (eg, the risk of avascular necrosis and delayed union or non-union), steps involved in bone fracture healing and various imaging modalities used for scaphoid fracture diagnosis. Types of fracture management such as casting and surgical intervention are examined. Factors that can negatively influence bone healing, such as certain disease processes and tobacco use, are also investigated. This article is a Directed Reading. Your access to Directed Reading quizzes for continuing education credit is determined by your area of interest. For access to other quizzes, go to www.asrt.org/store.     

Breast ultrasound elastography

Elastography is a newly emerging study of interest that can be especially helpful when used as an adjunct to conventional B-mode ultrasound in evaluating breast lesions. It is estimated that 80% of breast lesions currently biopsied prove to be benign. Reducing that percentage is advantageous to both patients and the imaging community. The specificity of conventional ultrasound when added to a mammography work-up needs improvement. Adding elastography may improve specificity. This Directed Reading describes different acoustic techniques used to obtain an elastogram and evaluation of scoring procedures. Major technique differences exist in imaging the elastic properties of tissue. This article is a Directed Reading. Your access to Directed Reading quizzes for continuing education credit is determined by your continuing education preference. For access to other quizzes, go to www.asrt.org/store.     

Inflammatory breast cancer: challenges and developments

Inflammatory breast cancer (IBC) is a rare and exceedingly aggressive type of cancer that is often mistaken for other conditions. Because it spreads throughout the breast tissue, imaging modalities are not sensitive enough to allow for a conclusive diagnosis. Treatment typically is patterned after treatment for aggressive non-IBC breast cancer. This article is a Directed Reading. Your access to Directed Reading quizzes for continuing education credit is determined by your area of interest. For access to other quizzes, go to www.asrt.org/store. This article also meets Medical Dosimetrist Certification Board (MDCB) CE requirements.     

Occupational lung diseases

Chest radiography and high-resolution computed tomography are indispensable tools in the detection, classification and characterization of occupational lung diseases that are caused by inhaling mineral particles such as asbestos, silicon-containing rock dust and other tissue-damaging antigens, nanomaterials and toxins. Radiographic evidence of occupational lung disease is interpreted with a patient's clinical signs and symptoms and a detailed occupational history in mind because of high variability in radiographic findings. This Directed Reading reviews the history, epidemiology, functional anatomy, pathobiology and medical diagnostic imaging of occupational lung diseases associated with inhalation of fine particulates in the workplace. This article is a Directed Reading. Your access to Directed Reading quizzes for continuing education credit is determined by your CE preference. For access to other quizzes, go to www.asrt.org/store.     

Diagnostic imaging of cerebrovascular injury

Each year, more than 1.4 million people suffer traumatic brain injury and about 700 000 strokes occur. Consequently, imaging for cerebrovascular injury is an important part of the imaging specialist's job. Computed tomography is accepted widely as the gold standard for imaging intracerebral hemorrhage; however, magnetic resonance imaging can be useful in defining the extent of injury and long-term evaluation of blood flow, water movement and chemical abnormalities that are useful in developing long-term treatment planning. In addition, this Directed Reading uses images of gross specimens to illustrate cerebrovascular injury. This article is a Directed Reading. Your access to Directed Reading quizzes for continuing education credit is determined by your area of interest. For access to other quizzes, go to www.asrt.org/store.     

Brain arteriovenous malformations

An arteriovenous malformation (AVM) is a particular abnormality of blood vessels. Brain AVMs are congenital, but symptoms usually do not appear until the second decade of life - if at all. The most common presenting symptom is a brain hemorrhage, but other possible symptoms include neurological deficits, seizures and headaches. Until recently, the gold standard for diagnosing AVM was conventional angiography. However, computed tomography and magnetic resonance angiography are now the first-line diagnostic tools for AVMs. This article reviews the presenting symptoms, diagnostic procedures and treatment options for brain AVMs, including embolization, micro-surgery and radiosurgery. This article is a Directed Reading. Your access to Directed Reading quizzes for continuing education credit is determined by your CE preference. For access to other quizzes, go to www.asrt.org/store.     

Fungal pathogens: an overview

Of all the classes of infectious agents--bacteria, viruses, parasites, worms and prions--fungi are perhaps the last to come to mind and the least understood by most health care providers. Although they rarely cause fatal disease, fungi can cause significant injury and illness. Fungal infections are both difficult to prevent and difficult to treat. In addition, fungal infections are likely to become more common because of the ongoing human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic, the aging population and the growth of treatments that alter patients' immune status. This review introduces fungi, the infections they cause, the risk factors involved, diagnosis and treatment. This article is a Directed Reading. Your access to Directed Reading quizzes for continuing education credit is determined by your continuing education preference. For access to other quizzes, go to www.asrt.org/store.     

Ethical dilemmas in today's nuclear medicine and radiology practice.

Throughout history, societies have developed their own codes of ethics, including those pertaining to the practice of medicine. In the United States, physicians have adopted a set of ethics based on religious values and historical teachings. We, as physicians, have been presented several codes of ethics, including the American Medical Association Code of Ethics and the American College of Radiology Code of Ethics. Over time, we have learned to appropriately apply these codes to our daily practice. With the advent of new technologies in imaging, we may lose sight as to the transfer of these principles to reflect current conditions. Recent history has shown a trend of new technology leading to potential misuse of this technology and further leading to stricter governmental regulations. It is the purpose of this review to give guidelines for dealing with new technologies, such as PET imaging, and we describe a radiologist's ethical responsibility in a doctor-patient relationship. A historical review of medical ethics will lead to discussions about various issues affecting radiologists and nuclear physicians. To be sure, not all ethical situations are black and white, and therefore there are many gray areas. The opinions expressed in this article are those of the authors and are based on extension of already established rules of ethical conduct.     

Radiologic technology educators and andragogy

Radiologic technology educators are in constant contact with adult learners. However, the theoretical framework that radiologic educators use to guide their instruction may not be appropriate for adults. This article examines the assumptions of the standard instructional theory and the most modern approach to adult education-- andragogy . It also shows how these assumptions affect the adult learner in a radiologic education setting.     

Comparative analysis of the Code of Professional Ethics in Bulgaria and the Hippocratic Oath, Declaration of Geneva and International Code of Medical Ethics

In this paper I aim at making a comparative analysis of The Code of Professional Ethics in Bulgaria (CPEB), The Hippocratic Oath, The Declaration of Geneva, and The World Medical Association International Code of Medical Ethics. Two problems of special interest are explored: whether the leading principles of fundamental ethical codes are presented in CPEB and whether the code itself is relevant to the current medical professional and social situation in the country. The conclusion reached after a step-by-step analysis is that CPEB attempts to cover a wide range of principles and problems in medical practice and corresponds with the fundamental ethical codes. Although the code is criticized in some points, it could be very useful, provided that it is well publicized in the profession.     

Radiation protection in pediatric imaging

The effects of medical radiation exposure in childhood can last a lifetime. As more American children are exposed to repeated diagnostic imaging examinations, concerns have been raised about the potential harm from early medical irradiation. Diagnostic imaging personnel have a responsibility to ensure strict and consistent observance of the "as low as reasonably achievable" (ALARA) principle. Radiation risks are greater for children, which makes strict compliance with radiation protection practices a public health imperative. Radiologic technologists play a central role in radiation protection for children. This Directed Reading reviews the biologic effects and risks of ionizing radiation among children and the use of radiation protection to minimize medical radiation doses in the pediatric population.     

Imaging correctional facility patients

More than 2.2 million people are incarcerated in the United States, and thousands of these men and women will be brought to medical facilities at some point during their arrest or incarceration. Radiologic technologists across the country conduct imaging procedures for correctional facility patients. Some technologists work within prison infirmaries or in mobile units parked on prison grounds. Others work in hospitals that have contracts with penitentiaries. Whether inside or outside prison walls, imaging of correctional patients requires awareness. This Directed Reading describes the prison environment in the United States, the most common diseases that prisoners have, special prison populations and safety measures for performing imaging procedures on patients in the custody of prison officials.     

Clinical assessment of affective behaviors

Practitioners enrolled in the ECE Program may obtain ECE credit by participating in the Directed Readings Program. One-half ECE credit is available by reading this article and completing the quiz found at its conclusion. The completed quiz (or a copy) must then be sent to the ASRT, Department of Education, together with the name and social security number of the ECE participant. The quiz will not be acknowledged or returned. Record of credit will be included in the participant's annual report. For those not enrolled in ECE, who wish to participate, ECE enrollment forms together with appropriate fee and the completed quiz may be submitted to ASRT. ECE approval for Directed Readings will be allowed for three (3) years from the publication date. Directed Readings are another service of the American Society of Radiologic Technologists--serving your professional needs.     

Assessment of continuing education needs: results of New Jersey survey.

This article is the result of a study that the authors conducted for the Council of Radiologic Technology Educators of New Jersey. The purpose of the study was (1) to determine if radiologic technologists thought continuing education was necessary; (2) to determine what technologists have done to date about continuing education in their own lives; (3) to identify the type of continuing education programs radiologic technologists want; and (4) to find out how radiologic technologists want continuing education programs to be designed.     

Nuclear medicine infection imaging

This Directed Reading introduces the reader to basic immunological processes related to infection scintigraphy and describes the radiopharmaceuticals used in this type of imaging. Following a discussion of radiation safety and infection control, the article explains various applications of nuclear medicine for detecting and assessing infection.