The Language of Medicine

13th edition
Davi-Ellen Chabner

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 Chapter 20
Radiology and
Nuclear Medicine

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 Chapter Goals (Slide 1 of 2)
• List the physical properties of x-rays.
• Identify diagnostic techniques used by
radiologists and nuclear physicians.
• Name x-ray views and patient positions
used in x-ray examinations.
• Describe the role of radioactivity in the
diagnosis of disease.

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 Chapter Goals (Slide 2 of 2)
• Recognize medical terms used in the
specialties of radiology and nuclear
medicine.
• Apply your new knowledge to
understanding medical terms in their
proper contexts, such as medical reports
and records.

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Chapter 20
Lesson 20.1

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 Introduction
• Radiology: medical specialty concerned with
the study of x-rays and other technologies
(such as ultrasound and magnetic
resonance) to produce and interpret images
of the human body for diagnosis of disease
• X-rays: invisible waves of energy
• Nuclear medicine: use of radioactive
substances in the diagnosis of disease

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 Personnel in This Medical Field
• Radiologist
• Nuclear physician
• Radiologic technologists
Radiographers, nuclear medicine technologists,
sonographers

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 Characteristics of X-rays
• Expose photographic plates
• Penetrate substances
• Invisible
• Travel in straight lines
• Scatter
• Ionization

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Diagnostic Techniques (Slide 1 of 2)
X-Ray studies
• Digital radiography
• Computed tomography (CT)
• Contrast studies
 Barium sulfate: upper GI, lower GI
 Iodine compounds: angiography, arthrography,
cholangiography, digital subtraction
angiography (DSA), hysterosalpingography,
myelography, pyelography

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 Diagnostic Techniques (Slide 2 of 2)

• Fluoroscopy
• Digital imaging techniques
• Interventional radiology
• Ultrasound
• Magnetic imaging or magnetic resonance
imaging (MRI or MR)

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 X-ray Positioning (Slide 1 of 6)
• Posteroanterior (PA)
view: posterior source
to anterior detector

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 X-ray Positioning (Slide 2 of 6)
• Anteroposterior (AP)
view: anterior source to
posterior detector

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 X-ray Positioning (Slide 3 of 6)
• Lateral view: in left
lateral view, source at
right of patient, to
detector at left of
patient

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 X-ray Positioning (Slide 4 of 6)
Oblique view: source
slanting direction at
angle from
perpendicular plane

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 X-ray Positioning (Slide 5 of 6)
To describe the position of patient:
• Abduction—movement away from the midline

• Adduction—movement toward the midline

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 X-ray Positioning (Slide 6 of 6)
To describe the position of patient:
• Decubitus—lying down on the side
• Prone—lying on the belly (face down)
• Recumbent—lying down (prone or supine)
• Supine—lying on the back (face up)

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 QUICK QUIZ (Slide 1 of 4)
1. Obstructing the passage of
x-rays:

A. radiopaque
B. radiolucent
C. radioisotope
D. radiopharmaceutical

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Chapter 20
Lesson 20.2

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 Nuclear Medicine
• Radionuclides/radioisotopes
Alpha particles, beta particles, gamma rays
• Nuclear medicine tests
In vitro: test tube
In vivo: in the body

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 In Vitro Procedures
• Analysis of blood and urine
Radioimmunoassay (RIA) uses radioactive
chemicals and antibodies to detect hormones
and drugs in the patient’s blood (for example,
digitalis detection, hypothyroidism in
newborns).

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 In Vivo Procedures
• Radioactive substance given directly to
patient to evaluate organ function or image
Radiopharmaceutical (labeled compound)
concentrates in organ
Scintiscanner (gamma camera) detection
instrument produces picture (scintiscan)

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 Procedures Using Radionuclides
• Bone scan • Single-photon
• Lymphoscintigraphy emission computed
• Positron emission tomography
tomography (PET) (SPECT)
scan • Technetium Tc-99m
• PET/CT scan sestamibi
(Cardiolite) scan
• Thallium (Tl) scan
• Thyroid scan
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 Focus on PET Scan
• Radioisotopes (emission of positrons) instead of
contrast x-rays
• Intravenous injection
• Concentrates radioisotopes in tissues where the
radionuclide is or is not being metabolized
• Useful in treating stroke, epilepsy, Alzheimer
disease, brain tumors, abdominal and pulmonary
malignancies

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 Focus on SPECT
• Intravenous injection of radioactive tracer
• Computer reconstruction of 3-D image
based on many views
• Detects liver tumors, cardiac ischemia,
diseases of bone and spine

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 Vocabulary (Slide 1 of 8)
Term Meaning/Definition
computed Diagnostic x-ray procedure that produces
tomography (CT) a cross-sectional image of a specific body
segment
contrast studies Radiopaque materials are injected to
obtain contrast with surrounding tissue
when shown on x-ray film
gamma camera Machine to detect gamma rays emitted
from radiopharmaceuticals
gamma rays High-energy rays emitted by radioactive
substances in tracer studies

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 Vocabulary (Slide 2 of 8)
Term Meaning/Definition
half-life Time required for a radioactive substance
to lose half its radioactivity by
disintegration
interventional Therapeutic or diagnostic procedures
radiology performed by a radiologist
in vitro Process, test, or procedure performed,
measured, or observed outside a living
organism
in vivo Process, test, or procedure is performed,
measured, or observed within a living
organism

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 Vocabulary (Slide 3 of 8)
Term Meaning/Definition
ionization Transformation of electrically neutral
substances into electrically charged
particles
magnetic resonance Use of magnetic field and radio waves to
imaging (MRI) produce sagittal, coronal, and axial
images of the body
nuclear medicine Medical specialty that studies uses of
radioactive substances in diagnosis of
disease

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 Vocabulary (Slide 4 of 8)
Term Meaning/Definition
positron emission Use of positron-emitting radioactive
tomography (PET) substances given intravenously to create a
cross-sectional image of cellular
metabolism
radioimmunoassay Test that combines radioactive chemicals
and antibodies to detect minute
quantities of substances in a patient’s
blood
radioisotope Radioactive form of an element ;
radionuclide

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 Vocabulary (Slide 5 of 8)
Term Meaning/Definition
radiolabeled Radiopharmaceutical; used in nuclear
compound medicine studies
radiology Medical specialty concerned with the
study of x-rays and their use in diagnosis
of disease
radiolucent Permitting the passage of x-rays
radionuclide Radioactive form of an element;
radioisotope

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 Vocabulary (Slide 6 of 8)
Term Meaning/Definition
radiopaque Obstructing the passage of x-rays
radiopharmaceutical Radioactive drug used for diagnostic and
therapeutic purposes
scan Image of an area, organ or tissue of the
body obtained from ultrasound,
radioactive tracer studies, CT, or MRI
scintigraphy Diagnostic nuclear medicine test using
radiopharmaceuticals and gamma
cameras to create images

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 Vocabulary (Slide 7 of 8)
Term Meaning/Definition
single photon Radioactive tracer is injected
emission computed intravenously and a computer
tomography (SPECT) reconstructs a 3D-image based on a
composite of many views
tagging Attaching a radionuclide to a chemical
and following its path in the body
tracer studies Use of radionuclide tags attached to
chemicals and followed as they travel
through the body

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 Vocabulary (Slide 8 of 8)
Term Meaning/Definition
ultrasonography (US, Diagnostic technique that projects and
U/S) retrieves high-frequency sound waves as
they echo off body parts
ultrasound Handheld device that sends and receives
transducer ultrasound signals
uptake Rate of absorption of a radionuclide into
an organ or tissue
ventilation-perfusion Ventilation and perfusion of a
studies radiopharmaceutical followed by imaging
its passage through the respiratory tract

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 QUICK QUIZ (Slide 2 of 4)
2. Which of the following is a handheld
device that sends and receives
ultrasound signals?

A. Gamma camera
B. Roentgenology
C. Radioisotope
D. Transducer
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 Combining Forms, Suffixes, Prefixes,
and Terminology (Slide 1 of 4)
Combining Form Meaning
fluor/o luminous
is/o same
pharmaceut/o drug
radi/o x-rays
roentgen/o x-rays

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 Combining Forms, Suffixes, Prefixes,
and Terminology (Slide 2 of 4)
Combining Form Meaning
son/o sound
therapeut/o treatment
vitr/o glass
viv/o life

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 Combining Forms, Suffixes, Prefixes,
and Terminology (Slide 3 of 4)
Suffix Meaning
-gram record
-graphy process of recording
-lucent to shine
-opaque obscure

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 Combining Forms, Suffixes, Prefixes,
and Terminology (Slide 4 of 4)
Prefix Meaning
cine- movement
echo- a repeated sound
ultra- beyond

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 Abbreviations (Slide 1 of 4)
Abbreviation Meaning
Angio Angiography
AP Anteroposterior
Ba Barium
BE Barium enema
C-spine Cervical spine films
CT Computed tomography
CXR Chest x-ray (film)
Decub Decubitus – lying down
DICOM Digital image communication in medicine
DI Diagnostic imaging

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 Abbreviations (Slide 2 of 4)
Abbreviation Meaning
DSA Digital subtraction angiography
ECHO Echocardiography
EUS Endoscopic ultrasonography
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F-FDG Fluorodeoxyglucose
Gd Gadolinium
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I Isotope of radioactive iodine
131
I Isotope of radioactive iodine
IVP Intravenous pyelogram
KUB Kidneys, ureters, bladder (series)
LAT Lateral

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 Abbreviations (Slide 3 of 4)
Abbreviation Meaning
LS films Lumbosacral (spine) films
L-spine Lumbar spine
MDCT Multidetector CT scanner
MR, MRI Magnetic resonance, magnetic resonance imaging
MRA Magnetic resonance angiography
MRV Magnetic resonance venography
MUGA Multiple-gated acquisitions (scan)
PA Posteroanterior
PACS Picture archival and communications system
PET Positron emission tomography
PET/CT Positron emission tomography/computed tomography
RAIU Radioactive iodine uptake (test)

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 Abbreviations (Slide 4 of 4)
Abbreviation Meaning
RFA Radiofrequency ablation
SBFT Small bowel follow-through
SPECT Singe photon emission computed tomography
99
TC Radioactive technetium
201
Tl Thallium-201
T-spine Thoracic spine
UGI Upper gastrointestinal (series)
US, U/S Ultrasound; ultrasonography
V/Q scan Ventilation-perfusion scan of the lungs

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 QUICK QUIZ: (Slide 3 of 4)
3. Which term refers to movement away
from the midline of the body?

A. Adduction
B. Abduction
C. PA
D. Inversion

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 QUICK QUIZ (Slide 4 of 4)
4. Which term refers to a patient lying
on the back?

A. Prone
B. Supine
C. Flexion
D. Decubitus

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