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Radiology 101

Community members learn about imaging basics at mini-medical school

Constantine A. Raptis, MD, assistant professor of radiology, compares his role as a radiologist to that of those searching for “Waldo,” the children’s book character who wears a red and white striped shirt and stocking cap while hiking around the world. But instead of looking for the cartoon character who is deftly hidden in a maze of activity with similarly dressed red herrings, radiologists search a myriad of internal body images to diagnose what may be wrong with patients. “I’m always looking for Waldo,” Raptis says.

That was just one of the messages delivered by Raptis during a recent presentation at Washington University School of Medicine’s Mini-Medical School. Begun in 1999, Mini-Medical School offers the general public (ages 15 and up) a unique opportunity to learn about medical education and patient care.

Raptis was one of 16 medical school faculty making presentations in the latest eight-week session. The program is in its 17th year, but this was a first-time event for Raptis, whose lecture was titled “Grey Anatomy: Medical Imaging and Radiation.”

Raptis had several objectives for his presentation. “I wanted the audience to learn about the five most frequently used modalities in modern imaging: conventional radiography, computed tomography, magnetic resonance imaging, ultrasound, and nuclear medicine. I also wanted them to understand the strengths and weaknesses of each modality and their application, as well as have a basic understanding of the effects of radiation.”

It was a tall order packed in a 60-minute time frame, which also included a patient case. Mini-medical students were challenged to identify the imaging test that would determine the correct diagnosis of a 46-year-old man experiencing severe chest pain potentially due to a myocardial infarction, pulmonary embolism, or aortic dissection.

After the lecture, Raptis fielded some questions from the audience. They included:

What type of radiology exam is a screening mammogram?
It’s basically the same technology as a chest X-ray but you are focusing on the breast.

Is calcium screening done with CT?
Yes. As a non-contrast CT, it’s just an exam of your heart. We’re looking to see if your vessels have any calcium on them or any narrowed areas. We use risk to stratify patients.

Why is the breast squeezed during a mammogram?
You wouldn’t be able to see through the breast if it wasn’t compressed. By flattening the breast
out, you are making it less thick so the X-ray can penetrate it at a dose that is reasonable.

How dangerous is it for me to stand in front of a microwave?
That’s not risky. You’ll be okay.

Why come to Mallinckrodt Institute of Radiology?
We have more than 100 diagnostic radiologists on our faculty with a wealth of accumulated knowledge. When you get an imaging exam at Mallinckrodt, it’s going to be read by someone who is a subspecialist in the body part being imaged. That, along with having the newest equipment available, is a huge benefit.

After the presentation, some participants milled around the lectern, waiting to talk to Raptis. They included a young man, a high-school senior. “He was interested in a career in medicine that involved computers and thought that radiology might be a good idea,” says Raptis. “I told him once he gets to college, he should try to touch base with some radiologists at that institution to shadow them and potentially get involved in some research projects.”

Like searchers for Waldo, the earnest high-school senior was on a seek-and-find mission. Raptis may have just helped him find his way.

Learn more about Mini-Medical School at Washington University School of Medicine.