TYPES OF MEDICAL PROCEDURES INVOLVING IONIZING RADIATION

Diagnostic radiology

Diagnostic radiology is medical specialization that uses ionizing radiation to examine the structure and functions of normal human organs and systems and their pathologies for prevention and diagnosis purposes. X-ray diagnostics is the most common method of diagnostic radiology. X-ray images allow diseases and injuries to be detected and diagnosed with the purpose of further treatment of patients. Since X-rays include ionizing radiation capable of accumulating energy in cells and causing tissue changes, it is very important to minimize the risk for patients. Medical staff should always keep in mind that the appropriate quality of X-ray images should be achieved using the minimum radiation doses.

Different methods of diagnostics:

  • X-ray radioscopy
  • X-ray imaging
  • Computed tomography
  • Linear tomography
  • X-ray blood irradiator
  • X-ray densitometry
  • Angiography

X-ray radioscopy helps to examine internal organs and localize pathologic processes.

X-ray imaging uses X-rays to produce a fixed image of any body part.

Computerized tomography (CT) is a scanning method in which the X-ray bundle passes through a thin layer of human body tissues in different directions. It is used for diagnosis of injuries, craniopathy and cerebral pathology, pathology of bones and soft tissues, blood vessels, and lungs and for radiotherapy planning in treatment of cerebral tumors or other soft tissue tumors.

Linear tomography (zonography) is used to produce X-ray layer-wise images. This method is mainly used to detect pathologies in lungs, bronchus, trachea, throat and biliary tracts and diagnose urological diseases.

X-ray blood irradiator is an X-ray unit that excludes the risks related to isotopes, but keeps the advantages of X-ray technology: fast processing of blood and its components. An X-ray blood irradiator is used in hematology and oncology.

X-ray densitometry is bone mineral density measurement, scanning of the whole skeleton in two or more dimensions. The measurement detects the most vulnerable parts such as femur neck, shin, wrist, forearm. This procedure helps to prevent osteoporosis.  

Angiography is X-ray imaging of blood vessels that helps to detect their malformation, permeability, possible damage, and benign and malignant tumors.

Radiotherapy

Radiation therapy (radiotherapy) is one of the methods used for treatment of tumor and non-tumor diseases. In case of cancer, ionizing radiation is used to destroy cancer cells and limit their growth. Radiotherapy can be performed only by experienced and highly qualified experts, radiologists and medical physicists with field-specific education and training and many years of experience.

Radiotherapy is delivered with the help of special equipment: therapeutic gamma units, linear accelerators and intracavity gamma-therapeutic devices (brachytherapy).

Radiation therapy is used as an independent method to treat cancer of:

  • Lip skin
  • Nasopharyngeal and mouth cavity
  • Tonsils
  • Larynx
  • Cervix (only in the early stages of tumor growth)
  • Early stages of lymphoma and sarcoma

In treatment of other types of cancer, radiation therapy is used only as part of a comprehensive treatment course.

There are several types of medical exposure in radiation therapy, depending on tumor irradiation particles:

  • particle therapy uses α- and β-particles, as well as neutron, electron and proton beams;
  • photon therapy uses γ- and X-rays. Combined radiation therapy (photons and particles) can also be used.

Nuclear medicine

Nuclear medicine is clinical medicine specialization that deals with the use of radionuclide pharmaceuticals that are biochemical compounds containing radionuclides in smaller (for diagnosis) or greater (for therapy) amounts.

Main elements of nuclear medicine:

  • Radiopharmaceuticals;
  • Auxiliary equipment (gamma cameras, single-photon positron emission computed tomography (SPET/CT), double-photon positron emission computed tomography (PET/CT).

Interventional radiology

Interventional radiology is clinical use of treatment and diagnostics.

Interventional radiology includes two stages. The first stage is radiological examination (X-ray imaging, computed tomography, ultrasound or radionuclide scanning) that helps to determine the nature of a disease and affected area. At the second stage, the medical practitioner, without interrupting the examination, undertakes necessary treatment: catheterization, puncture and prosthetics, which are often as effective as surgery.

Endovascular surgery is the most common among interventional procedures. It allows heart surgery to be performed by delivery of microscopic instruments through the blood vessels under control of X-rays.

Stomatology

Dental radiography is the most common X-ray procedure that makes 21% on the global scale. There are four types of X-ray procedures: intraoral radiography, panoramic radiography, cephalometric radiography, and cone-beam computed tomography. Single doses of X-ray procedures are small but medical staff should always keep in mind collective doses that cannot be neglected in any way.

According to SNRIU and IAEA