A radiologist or radiologist is a specialist doctor who focuses on conducting radiological examinations in order to detect, assist in diagnosis, and treat disease using imaging procedures,such as X-rays, CT scan, magnetic resonance imaging (MRI), nuclear medicine, to ultrasound.
In Indonesia, to get a radiology specialist (Sp.Rad), a general practitioner must take a radiology specialist education program for 7 semesters. Radiology is a medical science that uses radiation to scan the inside of the body, to detect and treat disease.
Field of Work for Radiology Specialists
Radiologists have an important role in examining and diagnosing various disorders from all fields of medical specialization, especially surgery, orthopedics, internal medicine, pediatrics/pediatrics, pulmonology (lungs), cardiology (heart & blood vessels), neurology (nerves), ENT ( Ear, Nose and Throat), eye, forensics, and obstetrics and gynecology. Radiological examinations are carried out with different tools, according to indications and requests from the referring doctor.
Radiological medicine can be divided into several main fields, namely:
General radiology (diagnostic radiology)
This field of radiology focuses on examining and diagnosing the causes and symptoms experienced by patients. This examination also plays a role in evaluating the condition and outcomes of patient care. The most common types of diagnostic radiology examinations include:
- X-ray (X-ray)
- Ultrasound (Ultrasonography)
- Fluoroscopy
- Mammography (X-ray imaging of the breast)
- Angiography (special X-ray of arteries and veins)
- CT (Computed Tomography) scan
- MRI (Magnetic Resonance Imaging)
- Positron Emission Tomography (PET imaging, PET scan, or PET-CT when combined with CT scan)
- Nuclear imaging.
In certain conditions, a radiology specialist will use a special substance called a contrast agent to sharpen and improve image quality, so that disease detection and diagnosis can be done better.
Scientifically, the field of general radiology is divided into several subspecialties, including:
- Head and neck radiology
- Chest (thoracic) radiology
- pediatric radiology
- Radiology of the urinary tract and genital organs
- Breast radiology
- Interventional radiology and cardiovascular (cardiovascular)
- Bone and muscle radiology (musculoskeletal)
- Gastrointestinal radiology
- Neuroradiology or radiology of the nervous system and brain
- Nuclear medicine
Interventional radiology
In interventional radiology medicine, radiologists use imaging studies, such as CT scans, ultrasound, MRI, and fluoroscopy, to help guide certain medical procedures. This image is useful to assist doctors when inserting a catheter or inserting surgical instruments through small incisions into the patient's body.
Interventional radiology examinations are often involved in treating cancer or tumors, blockages in arteries and veins, uterine fibroids, back pain, liver and kidney disease, lung disorders, urinary and gastrointestinal system disorders, to brain problems such as stroke. .
Interventional radiology procedures include angiography and insertion ring (stenting) in blood vessels, embolization to control bleeding, tumor ablation, fine needle biopsy of certain organs, breast biopsy, placement of a feeding tube (NGT or nasogastric tube), to insertion of a venous access catheter.
Radiology oncology
Radiology doctors in this field are in charge of prescribing and supervising every treatment plan for cancer patients using radiation therapy (radiotherapy). The radiology oncology doctor will also monitor the progress of the patient's condition, as well as adjust the patient's treatment.
Duties of Radiology Specialists
The main duties of a radiology specialist include:
- Determine the most effective and safe imaging test method for the patient.
- Carry out radiological examinations together radiographer (radiology technician).
- Analyze, evaluate, and read out the results of radiological examinations of patients.
- Determine the type of disorder and the severity of the patient's condition.
- Suggest further examination or treatment for the patient, if necessary.
Clinical Authority of Radiology Specialist
There are various clinical powers of radiology specialists. Following are the clinical powers of radiology specialists according to their fields:
- Chest (thoracic) radiology
The radiological examination procedures performed included conventional radiography (chest X-ray), CT scan of the chest cavity, ultrasound of the pleura.
- Musculoskeletal field
Radiological examination procedures performed include bone and muscle X-rays, bone CT scan, bone MRI, bone scan (bone scan), and ultrasound (Doppler) of joints and soft tissues.
- Urinary tract and genital organs
The radiological examination procedures performed included intravenous urography, retrograde/antegrade pyelography, urethrocystography, micturating cysto urethrography (MCU), urethrography, ultrasound (Doppler) urinary tract, testicular ultrasound, genitography, CT/MR urography, and MRI of the internal genital organs.
- Gastrointestinal tract
Radiological examination procedures performed include X-rays of the abdomen (abdomen), barium meal, barium enema (colon in loop), lopography, fistulography, CT colonoscopy, ERCP, CT/MRI of the gastrointestinal tract.
- Neuroradiology (nerves and brain)
Radiological examination procedures performed included CT scans and MRI of the brain and spinal cord, MR myelography, brain ultrasound.
- Interventional and cardiovascular radiology
Radiological examination procedures performed include angiography, venography, lymphography, myelography, transarterial embolization, guided biopsy (Fig.guiding biopsy).
- Breast imaging field
Radiological examination procedures on the breast which include mammography, breast ultrasound, MRI and CT scan of the breast, and ductulography (examination of milk ducts).
- Head-neck imaging field
The radiological examination procedures performed included conventional radiography, head and neck CT scan, head and neck MRI, neck ultrasound, sialography (salivary glands), and dacryocystography (tear glands).
- Nuclear medicine field
The radiological examination procedures performed included bone scintigraphy, renal scintigraphy, lymphoscintigraphy, thyroid scintigraphy, and hepatobiliary scintigraphy.
Medical Conditions That Can Be Detected Through Radiological Examination
Here are some medical conditions that can be detected by a radiology specialist through radiological examinations:
- Cancer and tumors
- Abnormalities in the lungs, such as: pneumonia, bronchopnemonia, tuberculosis, bronchitis, Chronic Obstructive Pulmonary Disease (COPD), pneumothorax, and hematothorax.
- Abnormalities in the gastrointestinal tract, such as: swallowing disorders due to achalasia, acid reflux disease, cholecystitis, peritonitis, bleeding in the gastrointestinal tract, hernias, to the presence of wounds on the walls of the gastrointestinal tract due to infection or inflammation.
- Disorders of the urinary tract, such as: urinary tract infection, kidney infection or pyelonephritis, obstruction of the urinary tract or bladder, enlarged prostate, and urinary tract stones.
- Abnormalities in the heart and blood vessels, such as: congestive heart failure, heart disease, atherosclerosis, heart valve disease, heart muscle disorders, varicose veins, deep vein thrombosis (DVT), and arteriovenous malformations.
- Disorders of the nerves and brain, such as: meningitis, encephalitis, cerebral infarction, stroke, cerebral hemorrhage, subdural hematoma, and hydrocephalus.
- Abnormalities in the reproductive organs, such as: testicular torsion, varicocele, ovarian cysts, uterine myoma (uterine fibroids), and uterine infections.
- Disorders of the musculoskeletal system, such as closed fractures, displacement of bones and joints, bone tumors, and soft tissue masses.
When to See a Radiologist?
Patients are advised to see a radiologist when experiencing symptoms that require further examination to confirm the diagnosis. Generally, patients are referred by general practitioners or can also be referred by specialist doctors who handle either in the hospital (inpatient), or when taking outpatient treatment at a polyclinic or doctor's private practice.
Preparation Before Radiological Examination
There are various tests that a radiologist can perform. Before performing a radiological examination, there are several important things that can support the diagnostic results, namely:
- Please arrive at least 20 minutes before your radiology appointment. If you must cancel or reschedule, contact the radiology unit at least 24 hours in advance.
- Prepare and bring a medical history report and a cover letter for radiology examinations from your treating doctor.
- Tell your doctor if you are pregnant, may be pregnant, or are breastfeeding. In most cases, X-rays will not be performed on patients who are pregnant.
- Don't forget to bring a complete identity card, also bring some supporting documents related to the examinations you did previously, for example the results of blood tests, X-rays, or CT scans.
- Also tell your doctor about any medications or supplements you are taking. Also inform if you have had any special medical procedures for the installation of assistive devices, such as pacemakers, cardiac rings, cochlear implants, spiral contraceptives, or bone pins.
- Some medical conditions, such as kidney failure, it is recommended to consult the doctor who handles the examination, regarding the possibility of preparation and special instructions that must be followed, especially if a radiological examination using a contrast agent will be performed.
- Some radiological examinations will ask the patient to fast or take certain medications beforehand. Make sure you are fasting and taking your medication as directed by your doctor.
- Different radiological examinations have different requirements and preparations as well. Make sure you consult a doctor who handles the examination.
Make sure the radiological examination is handled by a competent radiology specialist. You can ask for recommendations from the general practitioner who examines you. Make sure the doctor you choose is able to communicate well in explaining the disease and the treatment steps you need.
Also make sure the facilities and services of the radiology unit you choose are good, complete and friendly. If you want to take advantage of BPJS or other insurance, make sure the hospital is affiliated with BPJS or your insurance service provider. And don't forget to bring your insurance card with you when you check out.
A radiologist is an important partner in health care, and they work closely with general practitioners or specialists who treat a patient's illness to ensure the best possible care.
You should not delay the time to do the radiology examination that has been suggested by the doctor. This examination will help the doctor determine the treatment that will be given, to suit the disorder you are experiencing.