1. Who Is a Radiologist?

A radiologist is a doctor who specializes in imaging techniques. Diagnostic radiologists can help identify abnormalities, malformations, inflammation, fractures, ruptured blood vessels, blockages, presence of foreign bodies, stones, cysts, or tumors. Interventional radiologists diagnose and provide treatment via image-guided, minimally invasive techniques and laparoscopic procedures. Radiation oncologists use radiation therapy to treat cancer. To become a radiologist, after graduating from medical school, a doctor completes a residency in radiology. A radiologist may further complete a fellowship to specialize in one of the branches of radiology, such as vascular and interventional radiology, pediatric radiology, nuclear radiology, musculoskeletal radiology, endovascular radiology, abdominal radiology, cardiothoracic radiology, or neuroradiology.

Radiologists use different techniques to produce 2D and 3D images of the various parts of the human body, including x-rays (radiography, fluoroscopy), ultrasonic waves (ultrasonography, echocardiography, elastography), magnetic resonance imaging (MRI), positron emission tomography (PET), radioactive substances (nuclear medicine), magnetic particle imaging (MPI), and photoacoustic imaging. Radiologists are experts in interpretation of imaging test reports and usually work with other medical experts to diagnose diseases, determine treatment modalities, monitor the progression of a disease and help predict outcomes.

A radiologist can help diagnose virtually any disease, as long as it causes observable changes that can be captured by one of the techniques mentioned above. Common conditions include bone fractures, kidney and gallbladder stones, stroke, aneurysms, and cancerous or non-cancerous tumors. Radiologists may also help treat conditions such as heart disease, stroke, and benign or malignant tumors. They also assist in disease prevention by performing screening exams, such as mammography or chest x-rays.

2. When Should I See a Radiologist?

Your primary care provider or a medical specialist may refer you to a radiologist to assess an injury or to help diagnose a health condition or disease. You may also be referred to confirm a preliminary diagnosis, to monitor your condition, and to check if your treatment is working. Indications may include:

• Injuries and suspected fractures
• Developmental anomalies
• Abnormal blood or urine tests
• Bleeding (hemorrhage)
• Pain or swelling in a body part
• Fatigue, shortness of breath, or palpitations
• Problems controlling or emptying your bladder
• Swallowing of foreign objects
• Abnormal lumps in the breast or any other body part

3. What Tests Does a Radiologist Perform or Recommend?

A radiologist may interpret results of one or more radiologic diagnostic imaging scans. These tests include:

• X-ray imaging of the chest, abdomen, hands, legs, pelvis, head, spine etc.
• Fluoroscopy
• Ultrasonography, including echocardiography
• Mammography, breast tomosynthesis (3D mammography)
• Bone densitometry (dual-energy X-ray absorptiometry, DEXA scan)
• Magnetic resonance imaging (MRI)
• Computed tomography (CT) scan
• Positron emission tomography (PET scan)
• Nuclear scan
• Radiocontrast agent imaging including angiography, intravenous pyelography, hysterosalpingography, cystourethrography, barium enema, and others
• Myelography
• Computed tomography angiography (CTA) or magnetic resonance angiography (MRA)
• Elastography

4. What Procedures Does a Radiologist Perform or Recommend?

Vascular and interventional radiologists may perform minimally invasive procedures to navigate small medical devices at the desired location or perform laparoscopic procedures. These include:

• Angioplasty and stent placement
• Brachytherapy
• External beam therapy
• Gamma knife therapy
• Radioactive iodine therapy
• Proton therapy
• Stereotactic radiosurgery
• Nephrostomy and gastrostomy tube placement
• Biliary stent placement
• Embolization
• Thrombolysis
• Radiofrequency ablation
• Imaging-guided biopsy
• Peripheral arterial revascularization
• Endovascular repair of aneurysms
• Cryotherapy
• Vertebroplasty

5. What Questions Should I Ask a Radiologist?

You may want to ask these kinds of questions:

• Which procedure will you recommend?
• How should I prepare for the procedure? How does the procedure work?
• What will the procedure feel like?
• How many of this type of procedure have you performed?
• How long will the procedure take? Will I need anesthesia during the procedure? What type of anesthesia will I receive?
• What are the risks and benefits of this procedure?
• How can I minimize my exposure to the radiation during the procedure?
• What is my diagnosis? What caused my condition?
• Is my treatment working?
• Has my cancer receded or spread to other areas? Which stage is my cancer?