Radiology Adventures

Radiologists help doctors diagnose disease and trauma by using special equipment to create images of the structures inside the body, looking for areas of abnormality. There are several different kinds of procedures. X-rays are a very common type of examination. Traditionally, the technique involves the use of X-ray radiation and film. When the X-rays are aimed at one side of the body, film captures the radiation coming through the other side. Dense tissue (like bones) absorbs more of the radiation energy and shows up as white images. Soft tissue appears gray. Pockets of air (like in the lungs) absorb no energy and look black on the X-ray.

CT scans use several X-rays to create cross-sectional images of the inside of the body, providing more information than a single X-ray. The scanner is a large machine with a tunnel and a table. The patient is placed on the table, which slides inside the tunnel. The X-ray machine rotates around the patient on a machine called a gantry, taking a series of X-rays. These images are combined by a computer to create a detailed, cross-sectional view of the body.

MRI scans use a succession of magnetic field and radiofrequency pulses to create images. The patient is placed on a table and slid inside a narrow tunnel in the MRI scanner. The magnet first causes the hydrogen atoms to line up along the same orientation. Then, radiofrequency signals disrupt the alignment, sending the hydrogen atoms spinning to return to their original position. As the atoms spin, they give off a signal. Hydrogen atoms in dense tissue have a different signal than those in soft tissue. A computer picks up the signals, analyzes the information and creates fine, detailed images of tissue and structures, including blood vessels. An MRI scan typically takes about one hour. However, the scan is very noisy and some patients have a hard time staying in the tight space for a significant time. Thus, doctors may offer sedation to patients having an MRI scan.

X-rays, CT scans and MRI scans provide information on structures within the body. PET scans, on the other hand, look at the metabolic activity of cells. Thus, these scans are good for judging how well organs are functioning. First, a patient is given a radioactive isotope (the medication can be given orally, by injection or through an intravenous infusion). After giving some time to allow the drug to circulate through the body, a gamma camera is aimed at the area to be scanned. The camera picks up the level of radiation coming from a target site. The more metabolically active the cells are (as with cancer), the higher the uptake of radiation. Thus these areas will “light up” in a different color than areas with lower cellular activity.

The American College of Radiology estimates there were nearly 27,000 practicing diagnostic radiologists in the U.S. in 2003. About three percent of them are specifically trained in pediatric radiology.

Easing Kids’ Fears

For a child, a trip to the hospital can be quite scary. There are many unfamiliar faces, strange surroundings, noisy equipment, lots of questions and prodding and, sometimes, needle-sticking. A frightened child may be uncooperative and emotionally distressed during imaging scans. This can increase the time needed to perform the scans or interfere with the quality of the results. In some cases, doctors may need to sedate the child to perform the scans.

One method of easing a child’s fears in the hospital is through distraction. Through distraction, the child focuses on a more pleasurable stimulus, like a picture, movie or music, rather than the imaging procedure. Research suggests distraction can decrease distress and reduce the need for sedation for anxious children.

The Adventure Series

The Department of Pediatric Radiology at Children’s Hospital of Pittsburgh/UPMC in Pittsburgh, PA is piloting a program that takes distraction techniques to the extreme with a group of redesigned radiology suites called the GE Healthcare Adventure Series™. The suites are comprised of five kid-friendly themed rooms. Pirate Island is a CT suite decked out in a pirate décor. The CT machine looks like a pirate ship with a wooden steering wheel at the opening to the CT tube. Brown and blue decals on the floor look like a gangplank and water. A room vaporizer even gives off the scent of fresh coconut. Coral City is a CT room with an underwater theme and life-sized mermaids. The Cozy Camp room is a PET scanner with a campground theme. There is also a safari-themed Jungle Adventure and an MRI room with a Space Adventure theme. In addition to the themed rooms, the Adventure Series has four character mascots: Marcellus the Monkey™, Haley the Hippo™, Tillie the Tiger™ and Tara the Toucan™.

The GE Healthcare Adventure Series was developed in collaboration with GE Healthcare, the Children’s Hospital of Pittsburgh/UPMC, and the Betty Brinn Children’s Museum in Milwaukee, WI. Administrative Director of Pediatric Radiology, Kathleen Kapsin, R.T., R.M., says children react very positively to the themed experience. In fact, the rate of sedation for children having diagnostic or therapeutic radiology procedures at the hospital has decreased by nearly 30 percent, and among children having CT scans by 90 percent.

For general information about radiology procedures:

Radiological Society of North AmericaSociety of Nuclear Medicine