Radiology: Treatment, Effects & Risks

As an independent medical discipline, radiology supports both diagnostic and therapeutic purposes through the pictorial representation of body structures. The spectrum ranges from classic X-rays and sonography to complex cross-sectional imaging procedures such as CT or MRI. With its various examination methods, some of which are also supported by contrast media, radiology offers the possibility of meaningful imaging of all physical structures.

What is radiology?

As a distinct medical discipline, radiology supports both diagnostic and therapeutic purposes through the imaging of body structures. Radiology is a highly specialized branch of medicine that uses electromagnetic radiation and mechanical waves to produce images of individual body parts or internal organs. The main areas of radiology, which depending on the indication also uses contrast media on a case-by-case basis for clearer imaging, are diagnostic radiology (including its specializations such as pediatric, neurological or emergency radiology) and interventional radiology, in which therapeutic measures are performed under radiological control. Nuclear medicine and radiation therapy are closely related to radiology, but are considered independent medical subspecialties.

Treatments and therapies

Because of its variety of methods and specializations, radiology is able to provide appropriate imaging for any physical structure. Radiology plays a major role in complaints and diseases of the musculoskeletal system. Structures such as bones, ligaments, tendons and muscles can be reliably imaged in order to subsequently initiate optimal orthopedic, surgical or physiotherapeutic treatment. Internal organs such as the gastrointestinal tract or coronary vessels can also be reliably imaged using the available radiological examination methods. Beyond diagnostic and therapeutic purposes, radiology also has a range of examinations in its spectrum that can be used in the context of pre- or post-operative care (for example, mammography screening for the early detection of breast cancer or MRI-based clarification of surgical results). Due to rapid developments, neuroradiology, which depicts the structures of the central nervous system, has become an independent branch of radiology. Its usefulness lies, for example, in the emergency treatment of stroke patients, follow-up after brain tumor surgery, or optimal planning of intervertebral disc surgery.

Diagnosis and examination methods

Modern radiology uses a variety of imaging methods, each of which can be used not only with regard to the medical issue at hand, but also in coordination with special patient needs (e.g., open MRI in anxiety patients or native examinations in cases of contrast agent intolerance):

Sonography has become a proven standard radiology procedure – not least because of its lack of complications and almost arbitrary repeatability. Ultrasound diagnostics is an extremely gentle method of assessing organs (e.g., upper abdominal or reproductive organs) and their function that is also well suited for pregnant women. This method is limited in obese patients and in all organs that cannot be imaged or can only be imaged inadequately. Conventional radiography (projection radiography) allows radiologists to image body structures (e.g., bones or thoracic organs) with the aid of X-rays, often using contrast media to improve the assessability of organs; examples include vascular imaging such as angiography or phlebography, or fluoroscopy of the gastrointestinal passage after oral contrast media ingestion. A common X-ray examination in the field of cancer screening is mammography, which is often offered as part of a screening program. Computed tomography (CT), like sonography and MRI, is one of the cross-sectional imaging techniques in radiology. With short examination times, it provides detailed images without superimposition, for example of coronary vessels or the abdominal organs, and, like MRI, is also frequently used in tumor diagnostics. Because of the high radiation exposure, a careful consideration of the benefits by the physician is required in every case.Magnetic resonance imaging or magnetic resonance tomography (MRI) is a highly complex cross-sectional radiological imaging technique that uses strong magnetic fields and, if necessary, additional contrast agents (mainly gadolinium or iron oxide particles) to provide excellent information, especially when imaging the central nervous system or the heart in real-time MRI. The advantage over CT lies in the absence of ionizing radiation and contrast media containing iodine, as well as the better soft tissue contrast. As an independent sub-specialty of radiology, interventional radiology enables minimally invasive interventions under constant image control. Focal points here are, for example, the dilatation of occluded vessels, the stopping of bleeding in the gastrointestinal tract, or the sclerotherapy of certain tumors.