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New Technology Brings New Hope

Can lowering cholesterol and monitoring blood pressure help stave off dementia? It can be an integral part of the treatment plan in instances where cognitive loss is caused by neurovascular disease. On the other hand, it wonít help a tumor. Lapses in memory or judgment, moments of disorientation: These are not uncommon, particularly in individuals in their seventies, eighties, and beyond. But one symptom doesnít mean one cause. (Is it a stroke? A tumor? Those tangles in the brain weíve come to associate with Alzheimerís Ė or some other less common neurodegenerative disease?)

It wasnít so long ago that diagnosis had to be made on the basis of clinical features, and the process was not as easy as a lay person might imagine. While a major stroke will usually cause very recognizable symptoms, a small stroke may not. A person can have small strokes, and accompanying loss of cognitive function, and go undiagnosed for years or even decades. But this scenario is becoming, increasingly, a preventable one. The future is looking brighter for people with acquired cognitive impairment, and itís not just because new treatments are being developed. Itís also getting easier to distinguish between conditions with similar symptoms Ė and to recognize the conditions before serious damage occurs.

Scientists and technologists have a growing number of tools at their disposal. One is the CAT scan, which uses ionizing radiation. Another is the MRI or magnetic imaging resonance, which uses magnetic fields. The fMRI, or Functional MRI shows changes in blood flow and thus gives a picture of neural activity; it is frequently used to detect stroke.

Careers in Neurological Imaging and Diagnosis

Who operates these space age machines and interprets the results? Thereís a whole team of individuals involved in the process. At all levels, there are general paths that allow a person to be licensed or certified, and more specialized ones that increase the chances theyíll be employed in the desired specialty. Nuclear medicine is considered a branch of radiology; while MRIs do not use ionizing radiation, they come under the banner as well.

Diagnosis is done by a radiologist, a medical doctor who has pursued diagnostic imaging as a specialty. Neroradiologists are radiologists who have done additional training in neurological imaging. The training is extensive. The would-be neuroradiologist must be prepared to complete medical school and the traditional residency plus an additional post-residency fellowship. This allows her to be board certified in her sub-specialty.

Radiologists are assisted by nurses, technologists, and assistants. Technologists have some post-secondary education, though the amount varies. They may be generalists, who are trained to take x-rays and operate various imaging equipment, or they may specialize in nuclear technology or MRI. (From a career standpoint, it can be good to have a specialty Ė and a better idea to have more than one specialty.)

Radiologic technologists can, though experience and formal education, become radiologic assistants. The radiologic assistant is the radiologistís right hand Ė and a highly educated assistant at that. An RA has at least a bachelorís degree and often a masterís. In addition to performing complex technological procedures, he does some assessment. (In radiology, as in other medical branches, assessment is considered a step below diagnosis.) There are also more specialized degrees at the bachelorís and masterís levels. The University of Arkansas for Medical Sciences, for example, offers a Master of Imaging Science degree.

Biomedical Engineering

The science is exciting, and the machinery looks like it belongs to the space age, but like all health professions, careers in neurological imaging have their up sides and their down sides. Those who are fascinated by the technology, but donít want to be involved in patient care, have other options. They may be interested in biomedical engineering or biomedical equipment technology. Equipment technicians do just what the name implies: they keep machines running smoothly. Highly educated biomedical engineers, meanwhile, work on equipment design.