Professions in:

Diagnostic Radiology

Who is a Radiologist?

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Musculoskeletal radiologist using fluoroscopic images to plan an ankle arthrogram.

A radiologist is a physician who is also an imaging expert with specialized training in obtaining and interpreting medical images obtained by using x-rays (radiographs, CT, fluoroscopy) or radioactive substances (nuclear medicine) or by other means such as sound waves (ultrasound) or the body's natural magnetism (MRI).

Nearly all physicians examine patients, obtain medical histories, diagnose illnesses, or prescribe and administer treatment for people suffering from injury or disease. According to American Medical Association statistics, 1.2 percent of those physicians specialize in radiology. A radiologist correlates medical image findings with other examinations and tests, recommends further examinations or treatments, and confers with referring physicians (the doctors who send patients to the radiology department or clinic for testing). Radiologists also treat diseases by means of radiation (radiation oncology or nuclear medicine) or minimally invasive, image-guided surgery (interventional radiology).

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Drs. Elliot Fishman and Philip Alderson discuss the role of a radiologist.

Like other physicians, a radiologist must first graduate from an accredited medical school, earn an MD degree, pass a licensing examination, perform a year of internship, and complete at least four years of graduate medical education (residency) in radiology. Upon completing a residency, these doctors may choose to enter a fellowship program and sub-specialize in one or more areas of radiology.

Radiologists are usually board certified, that is, have taken and passed an examination and are thus approved to practice in the field by either the American Board of Radiology (for a medical doctor) or the American Osteopathic Board of Radiology (for an osteopathic doctor).

Subspecialties for Diagnostic Radiologists

A radiologist, through extensive clinical work and related research, may also specialize in one or more radiology subspecialties.

Breast imaging
The subspecialty of radiology devoted to the diagnostic imaging and diagnosis of breast diseases and conditions. This includes mammography, breast ultrasound, breast MRI, and breast procedures such as breast biopsy.

Cardiovascular Radiology
The subspecialty of radiology devoted to the diagnostic imaging and diagnosis of diseases of the heart and blood vessels (including the arteries and veins, and the lymphatics). This includes x-rays, CT (computed tomography or CAT), ultrasound and MRI.

Chest Radiology
The subspecialty of radiology devoted to diagnostic imaging and diagnosis of diseases of the chest, especially the heart and lungs. This includes x-rays, CT (computed tomography or CAT), Ultrasound, MRI and chest procedures, such as lung biopsy and drainage of fluid from the chest.

Emergency Radiology
The subspecialty of radiology devoted to the diagnostic imaging and diagnosis of trauma and non-traumatic emergency conditions. This includes x-rays, CT (computed tomography or CAT), Ultrasound and MRI.

Gastrointestinal (GI) Radiology
The subspecialty of radiology devoted to the diagnostic imaging and diagnosis of the gastrointestinal (GI) or digestive tract (the stomach and intestines) and abdomen. This includes fluoroscopy, x-rays, CT (computed tomography or CAT), Ultrasound, MRI, and GI procedures such as biopsy and fluid and abscess drainage.

Genitourinary Radiology
The subspecialty of radiology devoted to the diagnosis and treatment of the organs of the reproductive and urinary tracts. This includes x-rays, CT (computed tomography or CAT), MRI and procedures such as biopsy, kidney stone removal, and uterine fibroid removal.

Head and Neck Radiology
The subspecialty of radiology devoted to the diagnostic imaging and diagnosis of diseases of the head and neck. This includes x-rays, CT (computed tomography or CAT), Ultrasound and MRI.

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Radiological technologist preparing to take an arm x-ray on a patient.

Musculoskeletal Radiology
The subspecialty of radiology devoted to the diagnostic imaging and diagnosis of the muscles and the skeleton. This includes x-rays, CT (computed tomography or CAT), Ultrasound and MRI.

Neuroradiology
The subspecialty of radiology devoted to the diagnostic imaging and diagnosis of the brain and nerves, head, neck and spine. This includes x-rays, CT (computed tomography or CAT), Ultrasound and MRI.

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Pediatric radiologist scanning a boy's abdomen using ultrasound.

Pediatric Radiology
The subspecialty of radiology devoted to the diagnostic imaging and diagnosis of diseases of children. This includes x-rays, CT (computed tomography or CAT), Ultrasound, MRI and procedures such as fluoroscopy, biopsy and drainage of fluid or abscess collections.

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Interventional radiologist performing an angiography exam of a patient's leg vessels.

Interventional Radiology
The subspecialty of radiology devoted to the imaging, diagnosis and treatment of patients utilizing minimally invasive interventional techniques. This includes imaging and treatment of the blood vessels (such as angiography, angioplasty and stent placement), biopsy procedures, line and tube placement, uterine fibroid removal, fluid and abscess drainage, These can be performed with x-rays, fluoroscopy, CT (computed tomography or CAT), Ultrasound or MRI.

Nuclear Radiology
The subspecialty of radiology devoted to the imaging, diagnosis and treatment of patients with trace doses of radioactive material. This includes imaging of the heart, the skeletal system, and most organs in the body (for example the thyroid and parathyroid glands, liver, spleen, kidneys, lungs, etc.). It also includes the treatment of various conditions in the body such as a hyperactive thyroid gland and thyroid cancer. The imaging modalities include gamma imaging, PET, and PET/CT.

Radiation Oncology
The subspecialty of radiology devoted to the treatment of cancer with radiation. The radiation may be delivered from an outside x-ray source or may be injected into the body.

Radiologist Assistant

A radiologist assistant (RA) is a high level radiologic technologist (RT) who works under the close supervision of a radiologist to perform and assist with advanced tasks. Specifically, an RA performs radiologic examinations, is involved in patient management and evaluation, and assists the radiologist with invasive procedures. The RA also may be responsible for making preliminary judgments about image quality, making initial observations of images, and forwarding those observations to the supervising radiologist.

Although radiologist assistants are able to perform functions beyond those of a radiologic technologist, the position holds certain limitations. An RA may make initial observations of images but may not draft an official written interpretation. Radiologist assistants may not perform selected radiology procedures without radiologist supervision.

The RA position is a new addition to the diagnostic radiology team. Radiologist assistants complete an academic program and a radiologist-supervised clinical internship. An RA must be certified by the American Registry of Radiologic Technologists (ARRT). Currently, there are 10 Registered Radiologist Assistant (RRA) programs in the country recognized by ARRT; seven of these programs offer master's degrees.

Further information about a career as a radiologist assistant can be found on the American Society of Radiologic Technologists (ASRT) home page.

Radiologic Technologist

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Radiological technologist explaining the upcoming CT exam to a patient.

The radiologist usually receives assistance from a radiologic technologist. Primarily, a technologist operates the radiographic equipment to produce images. This involves explaining procedures to reassure the patient and obtain cooperation, positioning the patient on the examining table, and adjusting immobilization devices to obtain optimum views of specific body areas. The technologist moves the imaging equipment into position and adjusts equipment controls to set exposure based on knowledge of the procedure and on established guidelines. To prevent unnecessary radiation exposure during some procedures, a technologist uses radiation protective devices, such as lead shields, and limits the size of the x-ray beam. The technologist may also operate mobile x-ray equipment to obtain images in the emergency room, operating room, or at the patient's bedside. Technologists assist radiologists in the use of general radiology, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US). Depending on the type of radiologic procedure, one of the following may be assisting the radiologist:

  • CT technologist
  • MRI technologist
  • Sonographer (ultrasound)
  • Radiographer (x-ray)

Usually, a technologist has undergone two years of formal training or two - four years in an academic environment, leading to a certificate, associate's degree, or bachelor's degree. With additional training, a technologist can specialize and work almost exclusively with specialized radiographic equipment. Radiologic technologists are certified by the American Registry of Radiologic Technologists. To remain registered, technologists must complete Continuing Education (CE) credits.

More information about a career as a radiologic technologist can be found on the American Society of Radiologic Technologists (ASRT) website (www.asrt.org).

Radiologic Nurse

The larger medical centers may employ a radiological nurse who provides for the physical, mental, and emotional needs of the patient who is undergoing tests or treatment in a radiology department. The radiologic nurse usually develops and manages a care plan to help patients understand procedures and, later, recuperate from the procedures. This may also include working with a patient's family.

The nurse can perform examinations or carry out preventive health measures within the prescribed guidelines and instructions of the radiologist. In addition, the nurse can record physician findings and discuss cases with either the radiologist or other health care professionals. Often, a radiologic nurse will assist during examinations or therapy. Radiologic nurses must have graduated from an accredited nursing school. Each nurse must also pass a national licensing examination.

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