What are the various specialties and subspecialties within radiology?

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Radiologists specialize in obtaining and interpreting images for specific parts of the body. They can specialize in either diagnostic radiology, vascular and interventional radiology, or radiation oncology and can also become certified in a variety of subspecialties.

Diagnostic Radiologist
In order to diagnose and treat disease, a diagnostic radiologist will obtain and interpret medical images by using X-rays, CT scans, radiograph, fluoroscopy, MRIs, ultrasound, electromagnetic radiation, and radionuclides. A radiologist can connect medical images to other examinations/tests a patient is getting done, can recommend further treatments, and can inform the patient's primary physician with relevant information.

Vascular and Interventional Radiologist
A vascular and interventional radiologist can diagnose and treat benign and malignant conditions of the abdomen, pelvis, and thorax with imaging and image-guided minimally invasive procedures. Radiologic imaging technologies that they use may include fluoroscopy, digital radiography, CT scan, sonography, and MRI. Therapies and treatments can include angioplasty, stent placement, ablation, embolization, biliary and genitourinary drainages, abscess drainages, and thrombolysis. Interventional radiologists diagnose and treat their patients using the least invasive techniques available (these techniques amount to less risk, less pain, and less recovery time compared to open surgery).

Radiation Oncologist
A radiation oncologist is trained in the use of radiation therapy (radiotherapy) to reduce or eliminate the symptoms of cancer, and to treat malignant and some benign diseases. They may also use CT scans, MRIs, ultrasound, and hyperthermia to aid in treatment planning, as well as order tests, images, consult with other physicians, and prescribe medication. After treatment, radiation oncologists will evaluate the patient’s response to treatment and oversee the future care of the patient.

Subspecialties include:

A neuroradiologist is trained to diagnose and treat disorders and abnormalities of the brain, spine, and head and neck (this also includes the sinuses, spinal cord, and the central nervous system). They are able to interpret X-rays, angiography, myelography, MRIs, and CT scans which can help to diagnose strokes, tumors, genetic conditions, aneurysms, Alzheimer's disease, aging and degenerative diseases, cancer, seizure disorders, cerebrovascular diseases, and trauma. Neuroradiologists can perform minimally invasive treatments for disorders such as brain aneurysms, arteriovenous malformations, and compression fractures of the spine.

Pediatric Radiologist
A pediatric radiologist will diagnose, care, and manage congenital abnormalities, diseases specifically related to infants and children, and diseases that begin in childhood and can cause impairments in adulthood. They will use imaging and interventional procedures such as X-ray, ultrasound, CT scan, MRI, and nuclear medicine, interpret the results of the tests, and make an appropriate diagnosis. Pediatric radiologists also provide radiation treatment for children and teens affected by cancer.

Children tend to be more radiosensitive than adults, and have a longer life expectancy than adults. This may lead to a greater chance of developing cancer from exposures to ionizing radiation. The paediatric radiology community has long been aware of this issue and has developed radiation protection policies and practices that reflect this.

Nuclear Medicine Radiologist
A nuclear medicine radiologist administers trace amounts of radioactive substances (radionuclides) and uses techniques such as scintigraphy, which uses radiopharmaceuticals, in order to provide images and information for making a diagnosis and deciding on treatment. Imaging procedures include positron emission tomography (PET), and single photon emission computed tomography (SPECT) scans. Radioactive materials can be injected into a patient's vein, be inhaled, or can be swallowed. Radiopharmaceuticals are used to treat thyroid cancer, solid tumors, hyperthyroidism, hematologic malignancies, or painful bone metastases.

Thoracic Radiologist
Thoracic radiologists specialize in all aspects of lung disorders and airway diseases, such as: interstitial lung disease, chronic obstructive pulmonary disease (COPD), lung cancer (primary and secondary thoracic malignancies), mediastinal masses, pleural disease, occupational disorders, emphysema, as well as diseases affecting the large and small airways (such as asthma, bronchiectasis, tracheomalacia). Thoracic radiologists use state-of-the-art technology, such as high-resolution chest CT, CT angiography of the aorta and pulmonary arteries, and conventional chest radiography.

Musculoskeletal Imaging Radiologist
A musculoskeletal imaging radiologist orders and interprets medical images of bones, joints and associated soft tissues, and diagnoses injuries and disease. They do various types of diagnostic work, including sports injury imaging, tumors, arthritis, infections, and bone diseases by using X-rays, fluoroscopy, CT scans, ultrasound, and MRI scans.

A typical scenario where a musculoskeletal imaging radiologist would come into play - a patient goes to see their general physician with a problematic knee or shoulder, the doctor will then direct the patient to get a medical image where a musculoskeletal imaging radiologist will then carefully interpret the scan by using his or her diagnostic expertise. The patient's general physician will receive and review the imaging report sent from the musculoskeletal imaging radiologist and will coordinate the information with the patient's overall care.

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