Radiology is the medical specialty that includes the diagnosis and treatment of certain conditions through the interpretation of images taken with various imaging technologies. Those technologies include ultrasound, CT scans, nuclear medicine, PET scans, X-rays and MRIs.
“Radiologists expedite the diagnosis and ensuing treatments,” Dr. Rajeev Anugu says. He’s one of seven radiological specialists in Cedar Valley Medical Specialists (CVMS)’ group, all of whom work in the offices of the Radiology Department or Advanced Diagnostic Imaging (ADI). “One of my instructors said it best when he called us ‘consultants to consultants’. We interpret the images so other physicians have a better understanding of what is going on with a patient.”
There are subspecialties to radiology. For example, a colleague of Dr. Anugu, Dr. John Halloran, is an interventional radiologist, meaning he performs medical procedures, which are usually minimally invasive, in almost every organ system with the guidance of imaging technologies. Many conditions, like abscess drainage, that once required surgery can now be treated non-surgically by interventional radiologists.
CVMS also has the only pediatric radiologist in the area in Dr. Murali Surnedi. Pediatric radiology involves the imaging of infants, children, adolescents and young adults. The specialty has to take note of the varying dynamics in developing bodies and the radiation differences between adults and children. Children are more radiosensitive than adults and live longer, which may increase the risk of too much exposure to radiation.
Dr. Anugu is a neuroradiologist and focuses on the brain and spine. All physicians in the group are fellowship- trained or have special interests.
As mentioned above, radiologists do not just interpret the images obtained through the technologies, but also perform procedures. They conduct diagnostic biopsies on discovered masses with the aid of ultrasounds, or the draining of abscesses under local anesthesiology in perhaps an outpatient setting so the person can return home the same day.
If a person has difficulty swallowing, a barium exam may be required. Radiologists can drain fluid from the chest or abdomen. If a fall has occurred, radiologists may insert a needle into the spine for an injection of cement and the patient can return home in about four hours. Under appropriate conditions, radiologists even can remove a clot in the brain of a stroke patient. Allen Hospital is a primary stroke center and can have an image of the brain within 30 minutes of a stroke-alert person entering the hospital door.
Tomosynthesis is used in 3D mammography in order to create a three-dimensional image of breast tissue for better examination. CVMS’ physicians use this technology at United Medical Park to aid Dr. Douglas Duven and the Cedar Valley Breast Care Center. Dr. Anugu says this technology should be the standard of care.
“Radiology has advanced a lot because of technology,” Dr. Anugu says. “CT scans used to be nothing but an X-ray that showed the body in one slice. It took too long to get a picture of the entire body while the patient had to lay perfectly still. Now, we have CT scans that have 128 slices, and an entire scan can be done in 10 to 15 seconds.
“Right now, a lot of the focus is on reducing the amount of radiation on the patient. We have to determine what is right for the patient and what is right for the condition,” says Dr. Anugu. “Our CT scans have a lower dose of radiation but we don’t want to go so low that the imaging is not useful. We have to find the right balance,” Dr. Anugu says.
“Years ago we read X-rays from film. Now everything is digital. From my office, I can read an X-ray of a patient who lives in Grundy Center without having to physically drive to Grundy Center. Patient care is instantaneous.” Dr. Anugu and his colleagues’ focus always has been, and always will be, “patient care first.”
When intervention is needed, if complications arise after a surgery, they can address the problem to help prevent sending the patient back to surgery. Much of radiology is preventative medicine as much as diagnostic. Mammography is preventative if an abnormality is caught in the early stages. CT colonography has not been used as often as the usual colonoscopy, partially because radiation is involved. With improving technology to reduce radiation, this might be utilized more in the future, Dr. Anugu says.
CVMS’ radiologists are located at Allen Hospital, United Medical Park and ADI at the Cedar Falls and Waterloo locations.