Medicine is becoming more complex. In radiology, subspecialization enables a physician to know everything there is to know about one category of patients (children, for instance), one type of injury (sports injuries, for instance), one type of disease (like cancer), or one body system (the venous system, for example).
Nuclear medicine/Pet physicians
Like any other doctor, a radiologist undergoes at least 10 years of education before beginning practice. After their radiology education is completed, many radiologists complete an additional year or more of studies through fellowship training, specializing in a particular disease, such as cancer, or a specific organ system, such as the brain, heart, breast, musculoskeletal, digestive, or vascular systems. They are known as subspecialty radiologists.
Body imaging specialists diagnose and help treat diseases and conditions affecting major body organs and systems, including the lungs, liver, stomach, spine, pelvis, kidneys, colon, pancreas, other organs and throughout the abdomen. A subspecialized body imaging radiologist conducts imaging exams from the throat down to the pelvis up. These radiologists use many types of imaging, including MRI and CT to see inside the body in ways never before imaginable.
By specializing in the body cavity, body imaging physician experts are capable of focusing on additional nuances related to this area of human anatomy to deliver a more detailed analysis of the image. In addition to image interpretation and consultation, these physicians also perform a variety of minimally invasive, image guided procedures to assist their physician colleagues with obtaining a more definitive diagnosis and/or overall patient care, such as MR guided biopsies and stent placement.
Breast imaging radiologists are clinical experts who work as a team to use best practices for early detection of breast cancer, providing compassionate care and optimal outcomes. These radiologists do as much to prevent breast cancer as they do to treat it and are a vital part of any woman’s complete breast health. They must meet several criteria for quality and adhere to high standards of care.
Breast imaging subspecialists work hand in hand on a daily basis with breast surgeons, oncologists, radiation oncologists, OBGYNs, family practitioners, and more. They utilize a variety of procedures, depending on a patient’s needs. Breast imaging examinations/procedures include mammography, 3D mammography, ultrasound, MRI, elastography, breast biopsy, and breast needle localization.
Cardiac imaging subspecialists focus on imaging designed to manage heart disorders and assess the structure and function of the heart. They are a vital part of the process to catch and treat heart disorders in their earliest stages, ensuring the health and safety of the patient.
Common cardiac imaging techniques include cardiac MRI, CT coronary angiography, calcium scoring, SPECT, and PET CT. Cardiac MRI is particularly helpful in determining the extent of a heart attack, delineating between irreversible heart damage and heart tissue at risk of irreversible damage.
Other low or non-invasive cardiac imaging procedures include (but are not limited to) angiography, stent placement, aortic aneurysm repair, and cardiac calcium scoring. These imaging techniques are used to non-invasively evaluate the anatomy of the heart, bloodflow, and disease processes including aneurysm, dissection, or stenosis, among other things.
If you have an accident or experience a health care emergency, you likely will end up in an emergency room. Radiologists who specialize in emergency radiology have extensive experience interpreting traumatic and non-traumatic emergencies.
These radiologists are familiar with every organ system and imaging modality likely to be encountered in an emergency room setting. Common imaging tools used in the emergency room include x-ray, CT, and ultrasound.
Interventional Radiology (abbreviated IR or VIR for Vascular and Interventional Radiology) is a medical sub-specialty of radiology which utilizes minimally invasive image-guided procedures to diagnose and treat diseases throughout the body. The focus of interventional radiology is to care for patients using the least invasive techniques available in order to minimize patient complications and discomfort while improving health outcomes.
Interventional radiologists pioneered many techniques in modern minimally invasive medicine - including balloon angioplasty and the use of catheter delivered vascular stents. Using X-rays, CT, ultrasound, and MRI, interventional radiologists obtain images which enable them to direct therapeutic instruments throughout the body. These procedures are usually performed using needles and/or narrow tubes called catheters. In many instances, interventional radiology techniques eliminate the need for more invasive surgical procedures.
Examples of conditions treated by interventional radiologists include stroke, uterine fibroids, DVT, atherosclerosis, forms of cancer, internal bleeding, obstructions of the bile ducts and ureters, compression fractures of the spine, and a host of other common problems. By minimizing the physical trauma to the patient, imaging guided interventions can reduce complication rates, recovery times, and hospital stays.
Musculoskeletal (MSK) imaging radiologists focus on diagnosing bone and joint abnormalities, including orthopedic, rheumatologic, and traumatic conditions. Through advanced imaging technologies, MSK subspecialized radiologists are also able to study the anatomy and function of the soft tissue surrounding bones and joints, allowing them to directly observe these areas as the patient moves in a real-time. By specializing in musculoskeletal imaging, these physician experts are capable of focusing on additional nuances related to orthopedic and sports medicine injuries.
MSK imaging subspecialists work hand in hand on a daily basis with primary care physicians, surgeons, sports medicine and orthopedic specialists, and more. They utilize a variety of procedures depending on a patient’s needs. MSK imaging examinations/procedures include MRI, CT, ultrasound, x-ray, fluoroscopy, and even 3D imaging.
Neurological imaging subspecialists use a variety of techniques to obtain images of the structure and function of the brain to diagnose and treat a variety of conditions such as stroke, Alzheimer’s disease, cancer, headaches, MS, and brain tumors.
Subspecialized neuroradiologists work closely with neurointerventional specialists, neurologists, surgeons, primary care physicians, and others to provide a coordinated, informed, effective approach to neurological patient care. Neurological imaging procedures include MRI, PET, CT, and spectroscopy.
Nuclear medicine and molecular imaging subspecialists identify and treat diseases in their earliest stages through the use of small amounts of radioactive material, which is either injected, swallowed, or inhaled into the body. This allows specialized equipment to detect the radiation, producing a digitized image of the body’s tissue and organ function, rather than just anatomic structure. These images are often combined with patient anatomy via MRI or CT scans, allowing assessment of detailed images of form and function.
Nuclear medicine and molecular imaging allows radiologists to view the body at a cellular level and can help identify many diseases not detectable by other means. These imaging techniques are commonly used to evaluate the gallbladder, liver, thyroid, lungs, and heart without surgery. They also facilitate the early diagnosis of numerous diseases including cancer, often before symptoms appear, and can even assess the effectiveness of ongoing cancer therapy. Nuclear medicine therapy techniques allow for radioactivity to be targeted directly to diseased cells, sparing healthy tissue, unlike conventional radiation therapy. Nuclear medicine and molecular imaging physicians work hand in hand on a daily basis with surgeons, oncologists, family practitioners, and other healthcare professionals.
Although children often require the same type of radiology tests as adults, these tests can be very frightening to children because the tests cannot be easily explained to them. The challenge of a good pediatric imaging subspecialist is to provide a quality examination with the least amount of trauma to the child. Subspecialized pediatric radiologists are also American College of Radiology (ACR) certified, an additional qualification for pediatric imaging.
Children are also more susceptible to radiation than adults. It is important that your provider explain the type of testing that will be administered to your child, and ensure that they are using the lowest possible dose to ensure your child’s safety. More information about radiation protection in children can be found on the Image Gently website, www.imagegently.org.
Pediatric imaging subspecialists work hand in hand on a daily basis with pediatricians, surgeons, oncologists, and more. They utilize a variety of procedures, depending on a patient’s needs. Pediatric imaging examinations/procedures include x-ray, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and more.
Radiologists look for the presence of disease or pathology in medical images to the best of their professional ability. The most highly skilled radiologists have high accuracy rates and a low percentage of false positive exams. There always will be an important role for generalists in medicine, but a great deal of evidence supports the idea that subspecialization in radiology improves quality by:
REDUCING FALSE POSITIVES
A certain percentage of radiology studies are falsely interpreted as positive for disease or pathology. While false positives are inevitable in the highest quality radiology services, too many false positives increases unnecessary follow-up.
DECREASED COST AND WAIT TIMES
Subspecialized radiology can reduce the need for retakes, moderating costs to patients and insurers.
1. LINDGREEN EA, PATEL MD, MELIKIAN J, HARA AK. THE CLINICAL IMPACT OF SUBSPECIALIZED RADIOLOGIST REINTERPRETATION OF ABDOMINAL IMAGING STUDIES, WITH ANALYSIS OF THE TYPES AND RELATIVE FREQUENCY OF INTERPRETATION DISCREPANCIES. ABDOM IMAGING. 2014 0CT;39(5):1119-26.
2. BUIST, D.S., ANDERSON, M.L., HANEUSE, S.J.P.A. ET AL. INFLUENCE OF ANNUAL INTERPRETIVE VOLUME ON SCREENING MAMMOGRAPHY PERFORMANCE IN THE UNITED STATES, RADIOLOGY, 2011; 259; 72-74