Definition and Overview

Radiology is a branch of medicine that is involved in the use of imaging technology, which plays a key role in the diagnosis and treatment of a wide range of diseases.

A radiology consultation is an appointment with a radiologist to obtain his opinion about a patient’s condition and the best possible treatment. It is usually requested by the patient’s attending physician when important information is required to make an accurate diagnosis or when the patient requires an explanation as to how the scans can contribute to the treatment of his condition.

Radiology appointments do not always occur between a patient and a radiologist. In several cases, the meeting occurs between the two medical professionals to help the primary doctor determine the next medical intervention for the patient. In fact, in the past, it is usually the physician who meets with the radiologist. It is only recently that the number of patient consultations received by radiologists has increased.

Who Should Undergo and Expected Results

A radiology consultation makes a significant contribution to a patient's overall treatment program. There are two types of radiology procedures that are performed. These are:

  • Diagnostic radiology – this refers to radiologic scans that are used to detect any abnormalities and obtain specific clues as to what causes the patient’s symptoms. In other cases, diagnostic radiology is performed to confirm a suspected diagnosis. These scans offer crucial information, which is crucial in identifying the best treatment method for the patient. Screening tests to assess a patient’s risk of a particular disease also falls under diagnostic radiology.

  • Interventional radiology – Interventional radiology scans are used to:

  • Assess or monitor the patient’s condition or progress during treatments
  • Guide procedures

The use of radiology in guiding medical procedures allow doctors and surgeons to treat conditions using minimally invasive techniques, wherein procedures are performed using only small incisions or cuts. Guided by the images provided by radiology, doctors insert catheters, wires, a scope (camera), and other small tools that will guide them to the specific body part, and perform the actual procedure without the need for open surgery. These new waves of radiology-guided medical procedures allow patients to undergo surgery with minimal pain and bleeding as well as a shorter recovery time.

There are several types of medical imaging scans that are currently in use, and radiologists are trained in every one of them. These include:

  • X-rays
  • Magnetic resonance imaging (MRI) scan
  • Computed tomography (CT) scan
  • Positron emission tomography (PET) scan
  • Ultrasound
  • Mammography
  • Fluoroscopy
  • Nuclear medicine tests
  • Bone scans
  • Thyroid scans
  • Thallium cardiac stress test


These tests can help diagnose and treat a wide range of diseases, including:

How the Procedure is Done?

A radiology consultation begins with a request from a physician to consult a radiologist either for diagnostic or interventional purposes. If necessary, the physician himself will schedule an appointment with a radiologist.

In a diagnostic radiology consultation, the radiologist will be presented with all the information regarding the patient’s condition, particularly the symptoms being experienced. The radiologist will then recommend the most appropriate imaging scans in order to come up with an accurate diagnosis.

In an interventional radiology consultation, the physician and radiologist will discuss how imaging scans can be used to guide the surgeon during a medical procedure and what kind of scan will be most effective.

Despite the significant contribution they make at various stages of a patient’s medical care process, radiologists cannot treat patients by themselves. Their contribution is always presided by the primary physician attending to the case. Still, they can do patient consultations without a physician present. These consultations are often requested by patients who wish to obtain a second opinion or a different professional perspective about their conditions.

Possible Risks and Complications

Since radiology consultations are only initial discussions wherein possible imaging scans are discussed and planned, there are no risks involved.

In fact, this type of consultation plays an important role in protecting patients from the various risks involved in radiology scans. While scans are helpful in diagnosing and treating diseases, patients and physicians still need to be aware of the risks involved in these tests, and only a radiologist can provide complete information about this.

The main risk involved in radiology scans has to do with the effects of radiation on the body, particularly its tendency to damage healthy nerve cells and small blood vessels, which can lead to other potential complications. The faster cells divide and reproduce, the more likely they are to suffer from the effects of radiation, even at low levels. This risk, however, can be avoided by controlling the amount of radiation used in the scans. Some of the risks or possible side effects include:

  • Hair loss – Commonly occurs due to exposure to 200 rems of radiation

  • Heart problems – More likely with intense exposure to 1,000 to 5,000 rems of radioactive material

  • Seizures – Occurs when brain cells are damaged by radiation, which is only likely when as much as 5,000 rems of radioactive material is used

  • Reduced blood lymphocyte cells – Occurs when 100 rems of radioactive material is used, which leads to increased susceptibility to infections, increased risk of lymphoma or leukemia, and flu-like symptoms that can persist for as long as 10 years

  • Infertility – Can occur with as low as 200 rems of radioactive material

  • Irritation of the gastrointestinal tract – Typically occurs when 200 rems of radioactive material is used; this can lead to:

  • Nausea
  • Bloody vomit
  • Diarrhea

Other risks have to do with the:

  • Correct method of performing the scans
  • Accurate interpretation of scan results


Because of risks and possible complications, it is important that radiology consultations involve a discussion about how these risks can be avoided for the safety and protection of the patient.
References:

  • Zemen EM, Schreiber EC, Tepper JE. Basics of radiation therapy. In: Niederhuber JE, Armitage JO, Doroshow JH, et al., eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2013:chap 27.

  • National Cancer Institute. Radiation therapy and you: support for people who have cancer. Available at: http://www.cancer.gov/cancertopics/coping/radiation-therapy-and-you. Accessed May 29, 2014.

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