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More than 40 million imaging tests every year

In Spain, more than 40 million imaging tests are performed per year to diagnose or monitor different pathologies. On International Radiology Day, the Spanish Society of Medical Radiology (SERAM) takes us into this medical specialty where radiography continues to be the most prescribed.

Radiology: More than 40 million imaging tests per year


Children’s operating room at Hospital Sant Joan de Deu (Barcelona) with integrated magnetic resonance imaging. EFE/Marta Pérez

According to the World Health Organization (WHO), 80% of medical decisions in our environment are made based on
radiology tests, with an essential role of medical imaging (in all its varieties) in the diagnosis, follow-up and even in the treatment of the patient.

Of all the imaging tests, the X-ray remains the most used (45%), while 18% is tomography
computerized (CT or CAT), another 18% are ultrasounds, 9% magnetic resonance (MR), 5% mammograms
and another 5% from other medical imaging tests, according to SERAM data.

The radiologist doctor it is the person who decides the best test to do, the health professional who analyzes and interprets the images to give a diagnosis, and in the case of interventionism, the doctor who does the treatment.

According to president of SERAM, Dr. Asunción Torregrosa Andrés: “The current radiologist is not only a specialist who interprets images and prepares reports, but also a clinician, a consulting doctor who resolves the doubts of other specialists, who actively participates in multidisciplinary committees and performs not only diagnosis, but also minimally interventional image-guided invasive”.

Diagnose and intervene

In addition to the diagnostic aspect, radiology has an increasingly interventionist facet.

All radiological techniques allow interventional procedures to be carried out, both for diagnosis (fine needle punctures or thick needle biopsies) and for treatment, increasing day by day the number of pathologies that can be treated with minimally invasive techniques by interventional radiologists.

The selection of the most appropriate technique will depend on the characteristics of the lesion and the patient, the availability of equipment and the experience of the radiologists.

What each of the radiology tests consists of

Plain radiology or X-ray plates

The most performed test given its wide availability, easy performance, reproducibility, cost, safety and great diagnostic performance, especially in the evaluation of the thorax and bone lesions.

Computed tomography (CT or CT scan)

It also uses X-rays, but in this case it does not get a single image in one plane. The tube rotates around the patient emitting X-rays that are collected by a plate with multiple detectors. A sweep of the territory to be explored is carried out and, through computer processing, volumetric images are obtained with which to reconstruct in any plane of space or in three-dimensional form.

CT has a high spatial resolution allowing to see millimetric lesions that are not detectable in simple radiology studies and due to its speed and precision, it is the ideal technique for urgent pathology, allowing full body studies in a single and quick scan

International day of radiology
EFE/Rafael Díaz

mammography

Another test based on X-rays, which is used to study breast tissue. It is the fundamental technique of early detection programs for breast cancer and, together with ultrasound and magnetic resonance imaging, are the mainstays of breast pathology management.

ultrasound

Ultrasound is a diagnostic imaging technique that uses ultrasound as a source of image production. Due to its cost, availability, portability, versatility and the possibility of performing a dynamic examination while actively listening to the patient, it is a technique that has a very high diagnostic yield and multiple fields of application.

The main limitation of ultrasound is determined by the disturbances in the transmission of sound in bone and in air, which makes it difficult for ultrasound to evaluate structures with air (such as the lung) or protected by bone.

Magnetic Resonance (MRI)

Radiological diagnostic technique based on the tissue’s response to being subjected to a very powerful magnetic field and excited by radio frequency pulses. The operation is complex and involves multiple physical processes. The studies are longer and the collaboration of the patient is very important.

Safety is a fundamental element in the test, and it is essential to know if the patient is carrying any incompatible device.

This technique allows images to be obtained in multiple planes and sequences that provide both morphological and functional information.

And the main advantage over other imaging methods is the high contrast resolution that allows you to study tissues in great detail and makes it particularly useful for assessing the nervous system, musculo-articular structures and studying visceral injuries.

The procedure

All imaging tests may use contrast media, which are specific drugs that enhance the visualization and study of tissues, cavities or lesions.

The purpose of contrast media is not only the morphological study of structures, but they can also provide functional and dynamic information and allow healthy and diseased tissues to be distinguished. The main contrasts are gastrointestinal, intracavitary and intravascular.

Technological advances in radiology

In recent years, taking advantage of the digital characteristics of medical imaging, new tools are being incorporated that improve communication with patients, as well as treatment planning and the printing of 3D models, explains SERAM.

In the same way there are computer applications that improve the diagnostic process such as radiomics (which converts
images into quantifiable data and allows us to detect patterns related to aggression or response to the treatment of some injuries) or the artificial intelligence that allows us to automate some tasks of classification and even detection of injuries.

All these new techniques will make it possible to extract more information from scans, but at the same time they generate much more information that requires time and dedication from radiologists to be evaluated.

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