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Radiologist

A disease can be detected not only through laboratory or pathology tests, but also through the use of various imaging equipment. When performing a diagnostic imaging test, it should be under the supervision of a radiologist.

A radiology specialist is someone who has expertise in detecting diseases or health problems through the aid of imaging / radiation devices. Not only is it useful for knowing the type of health problems suffered by patients, radiology can also be implemented as a means to treat diseases.

Imaging procedures performed by radiologists typically utilize devices that emit mechanical or electromagnetic waves, such as through CT scans, MRI, X-rays, ultrasound, or nuclear tests like the Positron Emission Tomography (PET) Scan. There is also imaging that is used to see parts of the body that are undetectable by physical examination. Imaging tests produce medical images that will then be interpreted and analysed by a radiologist.

A radiology specialist doctor plays an important role in supporting various fields of medical specialties to help determine the diagnosis and medical procedure required to treat patients. Medical specialties that correlate with radiology specialists include orthopaedics, internal medicine, paediatrics, surgery, cardiology, neurology, pulmonology, forensics, to obstetrics and gynaecology.

Sub-Specialties in Radiology

In radiology, there are three main sub-specialty areas that are differentiated by the purpose and medical procedures performed. The three sub- specialties are general radiology, interventional radiology, and radiation oncology.

  • General radiology, or also known as diagnostic radiology, a sub-specialty in radiology that focuses on examinations and is used to determine the diagnosis of diseases or health problems suffered by patients through imaging tests. General radiology can also be implemented to monitor the progress of patients who have undergone treatment. In its development, general radiology is divided into several sub-specialties that are more focused in treating patients. The types of sub-specialties are:
    • Paediatric radiology
    • Chest (thoracic) radiology
    • Head and neck radiology
    • Breast radiology
    • Gastrointestinal radiology
    • Urologic radiology
    • Musculoskeletal radiology
    • Neuroradiology
    • Interventional and cardiovascular radiology
    • Nuclear medicine

There is also general radiology that can be executed through the use of X-rays, mammography, ultrasound, fluoroscopy, angiography, CT scan, PET scan, PET-CT (combination of PET scan & CT scan), MRI, and nuclear imaging. In certain conditions, tests done by a general radiology specialist may involve a particular substance called a  contrast agent. This contrast agent helps improve the clarity and image quality of various imaging methods to get the right diagnosis for the patient.

  • Interventional radiology, a radiology sub-specialty that focuses on facilitating minimally invasive medical procedures. This minimally invasive procedure is performed to diagnose and provide medical treatment for a disease. Interventional radiology combines imaging and minimal invasive medical procedures such as catheters, inserting cameras, cables, and various other instruments into the body. An interventional radiologist can help provide treatment for health problems that occur in the internal organs, treat cancer, uterine fibroids, blockages in arteries and veins, and back pain. Imaging performed by interventional radiologists is usually through CT scans, MRI , Ultrasound, and fluoroscopy (imaging that produces a single image)
  • Radiation oncology, a radiology sub-specialty that focuses on helping treat health problems such as cancer and tumors. Where radiology is generally used to help detect disease, radiation oncology specialists use imaging technology to provide treatment through radiation therapy / radiotherapy. Radiotherapy is done by exposing the patient to a certain level of X-ray energy which aims to kill, and prevent the multiplication and spread of cancer cells in the body. A radiation oncologist is able to plan treatment according to the patient’s condition, as well as monitor the progress of the patient’s treatment. Even so, treatment with radiotherapy methods is not recommended for pregnant women as the radiation exposure may interfere with fetal development.

Diseases Treated by Radiologists

As mentioned earlier, the field of radiology serves many purposes in medicine. Although in general, radiology is used to help diagnose diseases in a more accurate way, it can also be used to support other medical procedures or to treat a disease.

Several medical conditions and health problems that can be handled by a radiologist in order to detect diseases and treat health problems include:

  • Various types of cancer and tumors.
  • Lung diseases such as bronchitis, tuberculosis, pneumonia, bronchopneumonia, pneumothorax,
  • Chronic Obstructive Pulmonary Disease (COPD).
  • Digestive system diseases, such as gastrointestinal injuries that cause bleeding, stomach acid, hernias, cholecystitis, peritonitis, infections or gastrointestinal inflammation.
  • Urinary tract diseases, such as urinary tract infections, urinary tract obstruction, prostate enlargement, kidney infections.
  • Brain and nerve diseases, such as stroke, cerebral haemorrhage, meningitis, hydrocephalus, encephalitis.
  • Coronary diseases, such as heart disease, congestive heart failure, heart muscle disorders, deep vein thrombosis, varicose veins.
  • Health problems surrounding the male and female reproductive organs, such as swollen veins in the scrotum (varicocele), ovarian cysts, testicular torsion, uterine infections, uterine fibroids.
  • Musculoskeletal system diseases, , such as displaced bones and joints, bone tumors, closed fractures, soft tissue mass disorders.

Medical Procedures That A Radiologist Can Perform

The radiologist has the ability to determine safe and effective imaging tests for patients to undergo, depending on the patient’s physical condition. In conducting the test, a radiology specialist doctor will be assisted by a radiology technician or radiographer, until the examination results are obtained. From the results of these tests, the radiologist will be able to analyse and evaluate the types of health problems and their severity. If necessary, the radiologist may also suggest the patient to do further tests.

In the scope of general radiology, below are the descriptions of medical procedures that radiologists can perform based on the sub-specialties:

  • Chest / thoracic radiology: provides radiological examinations through chest X-rays, pleural ultrasound, and CT scan of the chest cavity.
  • Musculoskeletal radiology: provides radiological examinations by performing X-rays of bones, X-rays of muscles, MRI of bones, bone scans, ultrasound of soft tissues and joints, CT scans of bones.
  • Gastrointestinal radiology: provides radiological examinations through colonoscopy CT, gastrointestinal CT, gastrointestinal MRI, abdominal x-rays, barium enema, lopography, barium meal.
  • Radiology of the urinary tract and genital organs: provide radiological examinations through urethrocystography, micturating cystourethrography, renal ultrasound, genitography, intravenous urography, retrograde / antegrade pyelography, MRI of internal genital organs.
  • Radiology of the nervous system and brain: provides radiological examinations through CT scans, MR myelography, brain ultrasound, MRI of the brain and spinal cord.
  • Breast radiology: provides radiological examinations through breast ultrasound, breast CT scan, milk duct test (ductulography), breast MRI, and mammography.
  • Interventional and cardiovascular radiology: provides radiological examinations through venography, lymphography, guiding biopsy, transarterial embolization, angiography.
  • Head and neck radiology: provides radiological examinations through CT scan of the head and neck, MRI, neck ultrasound, dacryocystography, sialography.
  • Nuclear medicine radiology: provides radiological examinations through scintigraphy of the kidneys, bones, thyroid, hepatobiliary, or lymphoscintigraphy.

When to See a Radiologist?

In general, a general practitioner or certain specialist doctors may suggest their patients to see a radiologist if further tests are required to detect health problems.

In addition, certain conditions can also be treated by radiologists. For example, treatment and therapy to cure cancer that can be performed by radiation oncology specialist doctors. Moreover, an interventional radiologist can provide assistance to insert a catheter.

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