Medical Imaging and Radiation Therapy Practice

The scope of practice of medical imaging and radiation therapy, as defined under the NSCMIRTP Act is the application of professional medical imaging technology knowledge, skills and judgement in the use of ionizing and non-ionizing radiation, magnetic fields, high frequency sound waves and other energy forms, in the provision of diagnostic and therapeutic modalities, in collaboration with other health care professionals, to achieve optimal health, wellness and functional performance, and includes the practice of: (i) diagnostic medical sonography, (ii) magnetic resonance technology, (iii) nuclear medicine technology, (iv) radiological technology, and (v) the practice of any other medical imaging technology discipline set out in the regulations.

Practice includes not only the delivery of clinical services, but also research, education, consultation, management, administration, information technology, regulation, policy or system development relevant to the foregoing, and other practices as taught in MIRTP programs in Nova Scotia.

Description of clinical practice for each role are presented below. These descriptions should not be interpreted as the totality of what is considered practice but rather a basic description of common areas of practice for each discipline.

What is a Diagnostic Medical Sonographer?

A Diagnostic Medical Sonographer (DMS) is a health care professional who utilizes high frequency sound waves (ultrasound) to perform imaging examinations of the human body. During an ultrasound examination, a sonographer uses an instrument called a transducer, or probe, on a patient over the area of the body being examined. As the probe is being moved around it sends high frequency sound waves into the body. These waves form echoes which bounce back to the ultrasound machine to determine the size, shape and consistency of soft tissues and organs. This information is relayed in real time to produce images on a computer screen. Ultrasounds are preferred when possible since there is no ionizing radiation.

The sonographer decides which images are essential to a patient’s care. Sonographers use their ultrasound education, technical skills, and understanding of the human body and its systems to decide if structures are normal or abnormal, and adapt the scan as needed throughout an examination. This information is then used by doctors to determine the necessary treatment or next steps for the patient. The quality of an ultrasound exam is very dependent on the skills of the sonographer who completes the scan.

Ultrasound exams provide key diagnostic information to doctors about a patient’s medical condition and assist in their treatment and care.

The role of the professional Diagnostic Medical Sonographer is diverse and dynamic, and sonographers are active in many areas of healthcare. These health professionals are employed in various health care facilities. Sonographers may also become educators, application specialists or sales representatives with medical equipment companies, or be involved in research.

  • Screening for various abdominal, cardiac, gynecological, musculoskeletal, obstetrical, urological and vascular pathologies.

  • Assessing the direction and velocity of blood flow in various vessels in the body.

  • Screening obstetrical patients to assess the fetal abdomen, biometry, brain, heart, reproductive organs, and skeletal system, as well as maternal structures.

  • Screening pediatric patients to assess the brain, abdomen, vasculature, heart, soft tissues and reproductive organs.

  • Explain the procedures to patients.

  • Answer questions as fully as possible.

  • Educate patients and family.

  • Position patients and equipment correctly.

  • Perform the required diagnostic exams and assist in interventional procedures.

  • Take required measurements of certain pathologies and normal anatomy.

  • Have knowledge of physical principles, including artifacts, and how they impact the scan quality and results.

  • Ensure equipment is working within required specifications.

  • Monitor patients before, during and after the procedure.

  • Comfort and provide emotional support to patients and family.

  • Formulate a technical impression which is discussed with the reporting physician.

There are numerous approved Diagnostic Medical Sonography programs available in Canada. A full list can be viewed here. In Nova Scotia, the program is a three-year diploma or a four-year degree program offered through Dalhousie University. Upon completion of this degree, you must then write a national entry to practice certification exam. Diagnostic Medical Sonographers (DMS) must be registered with NSCMIRTP to work in the province of Nova Scotia.

What is a Magnetic Resonance Imaging Technologist?

A Magnetic Resonance Imaging (MRI) Technologist is a health care professional who utilizes a strong magnetic field to perform imaging examinations of the human body. The unique nature of this technology presents special imaging, patient care, and safety requirements.

MRI was introduced as a diagnostic medical imaging tool in the 1980s to examine organs and structures inside the body. Since magnetic resonance does not involve the use of ionizing radiation, radiation protection is unnecessary. However, metal objects may pose a danger; therefore, patients with metallic and/or electronic implants must be carefully screened before their MRI to determine whether the implanted device can safely enter the magnetic field.

During an MRI scan, atoms in the patient's body are exposed to a strong magnetic field. The technologist applies a radiofrequency pulse to the field, which knocks the atoms out of alignment. When the technologist turns the pulse off, the atoms return to their original position. In the process, they give off signals that are measured by a computer and processed to create detailed images of the patient's anatomy.

  • The cardiovascular system.

  • Brain and spinal cord.

  • Bones, joints, and soft tissues, such as muscles and tendons.

  • Blood vessels and organs in the chest, abdomen, and pelvis.

  • It can also be used to study body chemistry (spectroscopy), and brain and body functions.

Information about MRI scan wait times in Nova Scotia can be found at the Nova Scotia Department of Health website.

  • Explain procedures to patients.

  • Answer questions as fully as possible.

  • Position patients and equipment correctly.

  • Operate the scanner.

  • Monitor patients before, during and after the exam.

  • Provide comfort and emotional support to patients and family.

  • Ensure the safety of patients and staff around the magnetic field.

  • Educate patients and staff.

  • Conduct computer analysis to produce diagnostic medical images.

  • Ensure equipment is working within required specifications.

Claustrophobia can be a problem for certain patients as MRI scans often require having the upper body in a body-length tunnel for 30-60 mins.

To be eligible to become an MRI Technologist there are two paths;

  • Taking an MRI program as a first discipline from a recognized program in Canada and then passing the Canadian Association of Medical Radiation Technologists (CAMRT) entry to practice exam

  • Taking an MRI program as a 2nd discipline. You must first have passed the national certification exam in Diagnostic Medical Sonography / Nuclear Medicine / Radiation Therapy /or Radiological Technology and then study to gain requirements in MRI. This takes an additional one year on average and includes several months of clinical training and successful completion of the national entry to practice exam.

For more information on MRI programs, follow the link to approved Canadian programs. All MRI technologists must be registered with NSCMIRTP to work in the province of Nova Scotia.

What is a Nuclear Medicine Technologist?

Nuclear Medicine Technologists carry out diagnostic imaging and some treatment procedures in hospitals or private medical clinics. They perform imaging exams that help identify the nature of a disease and how it is affecting the body based on changes in physiology. Their work also enables doctors to monitor a patient's response to treatment. Depending on the type of exam, it may take minutes to several days to complete imaging. Nuclear medicine involves the use of radioactive tracers that concentrate in specific organs when introduced into the patient's bloodstream.

Given in small amounts, usually by injection, the tracers expose patients to a very low-level of radiation for a short period of time. As the tracer emits radiation, a special detector, gamma camera or PET scanner is used to collect data. Nuclear medicine technologists use computers to process the data and produce images of the organ/s from different angles. Nuclear medicine takes advantage of the way the body processes the radioactive substances differently when there is a disease or pathology present in comparison to how it is processed in a healthy body.

  • In-vivo tests are measurements directly involving the patient.

  • In-vitro tests are measurements of samples taken from the patient (e.g. blood, urine, breath).

  • Evaluating coronary heart disease, and cardiac function.

  • Studying how the brain, heart, lungs, kidneys and other organs are functioning.

  • Determining the location of tumors.

  • Monitoring the progression of cancer and the results of cancer treatments.

  • Diagnosing hormonal disorders.

  • Assessing orthopedic injuries.

  • Explain procedures to patients.

  • Answer questions as fully as possible.

  • Educate patients and family.

  • Prepare the tracer (radio-pharmaceutical) prescribed.

  • Ensure that proper radiation handling and protection techniques are followed.

  • Administer the tracer.

  • Position patients and equipment correctly.

  • Perform the required diagnostic exams and therapeutic procedures.

  • Monitor patients before, during and after the procedure.

  • Provide comfort and emotional support to patients and family.

  • Conduct computer analysis to produce diagnostic medical images.

  • Perform quality control to ensure equipment is working within required specifications.

There are numerous approved nuclear medicine technology programs available in Canada. A full list can be viewed through the provided link. In Nova Scotia, the program is a four-year degree program offered through Dalhousie University. Upon completion of this degree, you must then write a national entry to practice certification exam. Nuclear Medicine Technologists must be registered with NSCMIRTP to work in the province of Nova Scotia.

What is a Radiation Therapist?

A Radiation Therapist is a health professional that delivers radiation therapy treatment to patients with cancer. In Nova Scotia, there is a Cancer Center in Halifax and in Sydney.

In Nova Scotia, radiation therapists are scheduled Monday to Friday days with rotating on call for emergencies after hours and on weekends. Because of the type of work that a radiation therapist does, they must have both the technical knowledge as well as compassion to work closely with patients that can range in age from infants to the elderly, and from very healthy to gravely ill. A radiation therapist may see the same patient every day for several weeks requiring a therapist to have the ability to build and maintain a positive rapport with patients and their families. Radiation therapists are key members of the cancer treatment team.

More than half of all cancer patients receive radiation treatments, which may be given in conjunction with other forms of treatment. They use focused beams of radiation to destroy tumors while minimizing harm to healthy tissues. Alternatively, treatment may involve placing radioactive sources directly into the patient's body. In order to destroy cancerous tissue, radiation therapy involves exposure to higher doses of radiation than are required for diagnostic imaging. It is therefore vital that the radiation be precisely targeted, and the patient's exposure carefully monitored.

  • Explain procedures and comfort patients and families.

  • Answer questions as fully as possible.

  • Position patients and equipment correctly.

  • Ensure that proper radiation handling and protection techniques are followed.

  • Monitor patients before, during and after the procedure.

  • Provide emotional support and perform patient education.

  • Performing treatment simulations.

  • Taking measurements.

  • Constructing and fitting accessory devices.

  • Determining radiation doses.

There are numerous approved radiation therapy programs available in Canada. A full list can be viewed through the provided link. In Nova Scotia there is no program, most Nova Scotia radiation therapists attend a program in Toronto with the clinical portion being offered at the Nova Scotia Cancer Center in Halifax. If interested in this program, please click the following link Michener Institute. Upon completion of this degree, you must then write a national entry to practice certification exam. Radiation Therapists must be a registrant of NSCMIRTP to work in the province of Nova Scotia.

What is a Radiological Technologist?

A Radiological Technologist is a health care professional who utilizes ionizing radiation (x-rays) to perform imaging examinations of the human body. Radiological technologists must enjoy working with people and be very adaptable to different situations. They are educated in anatomy, physiology, patient positioning, examination techniques, equipment protocols, radiation safety, radiation protection, and patient care. They are involved in a broad variety of procedures which cover a number of specialty areas.

  • Plain film radiological technology, i.e., x-rays of the chest, bones, joints, gastrointestinal studies, spine.

  • Mammography to detect breast cancer in its earliest stages.

  • Angiography to examine the heart, blood vessels and blood flow.

  • Fluoroscopy, i.e., real-time images that show movement.

  • Computerized tomography (CT scans), i.e., detailed cross-sectional images of the body.

  • Interventional radiography, which uses sophisticated imaging techniques to help guide catheters, vena cava filters, stents, etc., through the body, allowing for disease to be treated without surgery.

By radiological technologists performing high quality exams, physicians are able to use findings from the exams to make a diagnosis, prescribe an appropriate course of treatment and monitor treatment results.

  • Explain procedures to patients.

  • Answer questions as fully as possible.

  • Contribute to patient education.

  • Provide comfort and emotional support to patients and family.

  • Position patients and equipment correctly.

  • Ensure that patients, all staff and visitors are protected from radiation.

  • Monitor patients before, during and after the procedure.

  • Assist the radiologist for angiography and interventional procedures.

  • Operate the equipment.

  • Ensure equipment is operating within acceptable standards.

There are numerous approved radiological technology programs available in Canada. A full list can be viewed through the provided link. In Nova Scotia the program is a four-year degree program offered through Dalhousie University Upon completion of this degree, you must then write a national entry to practice certification exam. Radiological technologists must be a registrant of NSCMIRTP to work in the province of Nova Scotia.