Radiography vs. Radiology

  • Radiographers and radiologists assist in non-invasive procedures, referring physicians to analyze the condition and provide the appropriate treatment.
  • A radiographer’s knowledge in operating medical imaging technology allows the radiologist to obtain a precise image and careful diagnosis. Without radiographers and radiologists, patients may not be diagnosed with optimal accuracy (1).
  • The radiologists’ proficiency in medical imaging and diagnosing are advantageous for patients because they provide an independent opinion from the referring physician (2).
  • As opportunities for radiographers and radiologists increase, their professions are forecasted to have faster than average job outlook compared to other occupations (3).

Radiography

Radiography is an imaging technique utilized to view internal parts of the body or industrial components. This technique uses X-rays, gamma rays, or ionizing radiation to produce images essential for proper diagnostics.

Two familiar aspects of radiography are industrial radiography and medical radiography.

In medical radiography, there are several modalities used in producing images. The common modalities are projectional radiography (X-rays), computed tomography (CT scan), and magnetic resonance imaging (MRI).

A sonogram, another modality, uses high-frequency sound waves to create an image from inside the body. The sonographer often performs this procedure.

Other modalities involve a more in-depth view of specific areas in the body, such as angiography, fluoroscopy, positron emission tomography (PET scan), contrast radiography, dual-energy X-ray absorptiometry.

These techniques are essential for diagnostic imaging.

On the other hand, industrial radiography is used for non-destructive diagnosis of machines, buildings, or components.

Industrial radiography uses X-ray or gamma rays to show defects that cannot be seen by the naked eye.

X-ray and gamma rays can go through different materials, including soil, concrete, and water. This modality can be used for mechanical parts, gas and oil pipelines, and metal welding.

Radiology

Radiology is a branch of medicine facilitating in analyzing images produced by modalities, such as X-rays, CT, MRIs, ultrasounds, and PET.

Radiology is a discipline wherein medical images are used to diagnose and treat different conditions.

Interventional radiology (IR) is a specialty wherein the radiologist performs minimally invasive procedures using imaging techniques as guidance.

IR can be used for both diagnostic and therapeutic purposes. Examples of these procedures include angiograms, angioplasty, fluoroscopy, or biopsies.

These procedures are guided by real-time imaging to allow for precision and detection of abnormalities.

IR allows for the diagnosis and treatment of deep body structures without undergoing open procedures that require lengthy recovery time.

IR is also used for tumors and metastatic cancers. Procedures that treat cancer include radiofrequency ablation (RFA), transarterial chemoembolization (cut of tumor’s blood supply), and vertebroplasty (treatment for compressed spinal fractures).

Radiographer vs. Radiologist

Radiographers or radiologic technologists specialize in operating imaging equipment, such as X-ray machines, sonograms, CT scans, MRI scans, and PET scans.

A radiographer is a health professional who assists radiologists in producing images for diagnosis and treatment. The radiographer operates imaging machines on the instructions of the radiologist.

Job Responsibilities

Radiographer

A radiographer can be called radiology tech, radiologic technician, radiology technicians, or radiologic technologist.

Radiographers are stationed in the radiology and imaging department in hospitals.

A radiographer is a community college- or university-trained healthcare professional who uses their knowledge to assist patients in producing optimal imaging.

A radiographer is educated in human anatomy, physiology, pathology, and radiology.

Radiographers possess skills and knowledge in radiologic technology and imaging techniques to produce the best possible results and accuracy.

Radiographers’ job description includes the following:

  • Provide patient care and assistance.
  • Inform patients of the risks before the procedure.
  • Orient patients regarding radiation safety and provide radiation protection equipment (lead glasses, lead aprons, or breast shields).
  • Provide a questionnaire to the patient or next of kin (if the patient is unconscious). The questionnaire must be answered before the examination begins.
  • Obtain consent for the examination from the patient or next of kin.
  • Provide instructions and orient patients or next of kin on imaging procedure before they enter the imaging center.
  • Operate imaging equipment, including X-ray machines, MRI scans, CT scans, sonograms, and PET scans.
  • Provide diagnostic images or other media .
  • Report incidents to the employer, radiologist, or physician of the patient.
  • Justify and analyze radiographic images with radiologists.

Radiologist

A radiologist is a medical doctor who analyzes, diagnoses, and treats patients with medical imaging guidance. This profession has two sub-specialties, such as diagnostic radiology and interventional radiology.

A diagnostic radiologist specializes in interpreting medical images obtained using X-rays, sound waves, magnets, and radioactive substances (nuclear medicine).

Depending on the condition, the radiologist may recommend more imaging tests or treatments.

The radiologist then discusses the condition’s diagnosis with the referring doctor.

Radiology is a broad branch of medicine with several subspecialties, making the radiologists’ roles indispensable (4).

The radiologists’ expertise and knowledge in their field allow referring physicians to focus on treatment and predicting outcomes.

Also, a radiologist who is well-versed in the latest imaging technology is advantageous in providing diagnosis with optimal accuracy.

A diagnostic radiologist can be trained in several subspecialties, such as cardiovascular radiology, pediatric radiology, and interventional radiology.

A general radiologist is experienced in all subspecialties. Frequently, general radiologists can be found in smaller cities’ institutions or hospitals.

Interventional radiology is when a radiologist performs a treatment following a diagnosis. Examples of these procedures are angioplasty (following an angiogram), needle biopsies, tumor ablation, feeding tube placement, radiation therapy, and embolization.

The interventional radiologist works closely with the patient’s primary physician.

In procedures such as angioplasties, a cardiovascular radiologist works with the cardiologist.

In radiation therapy (cancer treatment), the radiation oncologist (radiologist) works closely with the oncologist, radiation therapist (radiographer), and radiation physicist.

Radiologists’ and interventional radiologists’ job descriptions include the following:

  • Obtaining and review patient records or history
  • Prepare a comprehensive report of findings.
  • Perform or instruct radiographers of diagnostic imaging procedures, including MRI, X-ray, CT, and PT
  • Operate diagnostic equipment
  • Perform treatments following a diagnosis (interventional radiology)
  • Provide an independent diagnosis and discuss this with the referring physician or clinical specialist
  • Address patient’s concerns over the phone
  • Be on-call for emergency procedures

Some radiologists are also involved in several technological developments.

The advancement of cutting-edge medical imaging requires the advice of seasoned radiologists.

The evaluation of specific imaging equipment has been crucial for engineers. Radiologists also assist in developing imaging algorithms and apply these in a clinical setting (5).

More, radiologists’ participation in developing technology resulted in enhanced tissue differentiation and image clarity (6).

Education

Radiography

A prospective radiographer must be a high school graduate who may then select from available degree programs that lead to a bachelor’s degree in medicine, associate’s degree, or a certificate.

Aspirants must be educated in anatomy, pathology, patient care, medical ethics, radiation physics, and protection.

Once the degree has been obtained, radiographers must pass a certification exam from the state or certifying body.

The certifying body for radiographers is the American Registry of Radiologic Technologist (ARRT). MRI technologists must pass a certification exam from the American Registry of Magnetic Resonance Imaging Technologists (ARMRIT).

Some universities provide several educational programs for aspirants or licensed-radiographers who want to further their education. The educational programs must be accredited by the Joint Review Committee on Education in Radiologic Technology (JRCERT).

A career path to radiography requires one to four years of education. Aspirants can choose between a four-year bachelor’s degree or one to two years of associate’s program.

Specialties in radiography depend on the level of education attained by the individual.

Radiology technologists are required to finish a two-year associate degree program, while MRI technologists are required to attain a bachelor’s degree in medicine.

In the United Kingdom (UK), radiography programs require four years to complete. Prospects who want to further their education may enroll in postgraduate programs, which take two years to complete.

Once the required education has been attained, radiographers must register with the Health and Care Profession Council (HCPC).

Radiology

The educational requirement for radiologists is similar to doctors in other medical fields.

Individuals who want to become a radiologist must attend four years of medical school. Once the prospective radiologist attains a bachelor’s degree in medicine, they must work two years as a medical intern in an accredited hospital.

After two years of clinical rotations, prospects must serve four years of radiology residency. Radiology residents may continue their education while practicing.

Additional education programs are also available for radiologists who want to expand their specialties.

A prospective interventional radiologist must serve two years of fellowship training after completing their residency. Radiologists may pursue a master’s degree or graduate school.

Moreover, the continuing developments of cutting-edge technology in medical imaging requires radiologists to undergo further training.

In the UK, prospects must also undergo extensive education and training. A bachelor’s degree in medicine in the UK takes five to six years to complete. The degree must be recognized by the General Medical Council (GMC).

After attaining a bachelor’s degree in medicine, prospects must finish a two-year foundation program (equivalent to a two-year medical internship in the US).

The last training period for prospective radiologists is a five-year specialty training program.

Career

Radiography

The U.S. Bureau of Labor Statistics (BLS) reported that the average annual salary for all radiographers or radiologic technologists is $62,280 in 2019 (7).

Depending on the subspecialty, the average salary may be higher or lower. According to BLS’s 2019 annual salary information, the median income for radiographers are the following:

  • MRI technologist – $73,410 per year
  • Radiology technologists – $60,510 per year
  • Cardiovascular technologist – $57,720 per year
  • Nuclear medicine technologist – $77,950 per year
  • Radiation Therapist – $85,560 per year

*These statistics do not include self-employed radiographers.

In the United States, the job outlook for radiographers is higher compared to other occupations.

Projected job growth of MRI technologists is 11%, while radiology technologists’ job growth is 9%. These statistics are projected for 2019-2028.

BLS mentioned that the employment growth for radiographers is due to the aging population in the country. As the population grows older, health conditions that need medical imaging also rise.

Radiographers may further their careers by taking additional education programs and keeping updated with the latest technologies in medical imaging.

High-quality continuing education programs and financial aid are offered by universities and associations, such as the American Society of Radiologic Technologists (ASRT).

Entry-level and experienced radiographers may be required by the employer to pass certification exams even if they are not required by the state.

In the UK, a full-time radiographer’s annual salary is highly-competitive.

The National Health Service (NHS) estimated salary for radiographers in 2020 (8):

  • Trainee radiographer – £25,000 to £28,000 per year
  • Radiographer – £24,907 to £30,615 per year
  • Senior CT radiographer – £31,365 to £37,890 per year
  • Interventional radiographer – £31,365 to £37,890 per year

Radiology

In the United States, the salary of radiologists is the same as other physicians and surgeons. BLS estimated that the annual salary for physicians (including radiologists) in 2019 is more than $208,000 per year (9).

Physicians involved in diagnostics and treatment can look forward to 11% growth in occupational outlook from 2018-2028.

In the UK, the annual salaries of radiologists depend on the scope of expertise. The NHS job vacancies offer £79,860 to £107,668 per year for consultant radiologists (10).

Can a Radiographer Become a Radiologist?

A radiographer must follow the educational path of a radiologist to become a licensed physician. Radiographers who already attained a bachelor’s degree in medicine may proceed to join medical internship programs.

Radiographers with an associate’s degree or certification must attain a bachelor’s degree to qualify for the medical internships.

After completing internship programs, prospective radiologists must serve four years of residency.

Lastly, depending on the subspecialty, prospects can serve a two-year fellowship training under an attending radiologist.

What Are the Types of Medical Radiography?

Projectional radiography or conventional radiography produces a two-dimensional medical image. This technique exposes the human body to X-rays or electromagnetic radiation, wherein the resulting image is captured on a photographic film.

The image provides a view of bones and some organs, such as the lungs, blood vessels, breasts, and heart.

Bone radiography (bone X-ray) is used to analyze the extent of injuries and bone-related conditions in the body and extremities.

Mammography (or mammogram) is the X-ray image of the breasts. Physicians use mammograms to detect and analyze breast diseases, previous cosmetic surgeries, and hormonal changes.

Chest radiography (chest X-ray or CXR) is used to view the thoracic cavity and its contents, such as the heart, lungs, thorax, tracheobronchial tree, and pleurae. A vague shadow of the breast can also be seen in a chest X-ray.

Recently, CXR has been used to diagnose coronavirus infections, such as COVID-19.

A study published in La Radiologica Medica found that CXR showed nodular opacities on COVID-19 patients. The authors added that CXR has a sensitivity of 68.1% sensitivity in detecting the extent of infection (11).

Dual-energy X-ray absorptiometry (DEXA) or bone densitometry uses small doses of ionizing radiation to produce images. DEXA is often used on the lumbar spine and hip bones to measure bone loss (osteoporosis).

Computed tomography (CT) is a combination of projectional radiography images taken from different angles. This technique is often used for diagnosing internal injuries, muscle and bone disorders, tumors, infections, and blood clots.

Magnetic Resonance Imaging (MRI) is a technique that uses strong magnetic fields and radio waves to produce images of a patient’s physiological processes. MRI scans are useful for detecting conditions in the brain, arteries, heart, liver, gastrointestinal tract, and other parts of the body that need more in-depth imaging.

Positron emission tomography (PET) is a nuclear medicine procedure that uses a radioactive drug (tracer) to reveal tissues and organs’ functions. Depending on location in the body needed for medical imaging, tracers can be inhaled, swallowed, and injected.

Fluoroscopy is a technique wherein real-time moving X-ray images are displayed. Fluoroscopy allows the radiologist to see how a patient’s organs function.

Fluoroscopy is used for procedures, such as lumbar puncture, catheter or stent insertion, urological surgeries, orthopedic surgeries, barium X-rays and enemas, angiograms (viewing of the blood vessels), and many more.

Sonography uses high-frequency sound waves (ultrasound) to produce an image of organs, tissues, and blood flow. Sonography provides real-time continuous images that can be used during biopsies.

Conclusion

Radiography and radiology are both essential factors in medical imaging and diagnosing health conditions.

Extensive education, training, and systematic cooperation are needed to produce accurate images of the body.

Radiography and radiology are two different professions that require distinct types of education, training, and specialty. Most people often confuse one profession for the other.

Although both roles seem similar, they are different when it comes to expertise and knowledge provided for patients undergoing exams in the radiology department.

The job outlook for radiographers and radiologists is rising due to the aging population and increasing demand for medical imaging services.

Moreover, new technologies are coming up with new ways to look inside the human body.

Radiographers and radiologists spend years in education and training to produce optimal images and provide an accurate diagnosis.

These factors are why both professions are indispensable in the healthcare industry (12).


  1. European Society of Radiology 2009 (2010). The future role of radiology in healthcare. Insights into imaging, 1(1), 2–11. https://doi.org/10.1007/s13244-009-0007-x
  2. Ibid
  3. US Bureau of Labor Statistics. Radiologic technologists. Op cit.
  4. Margulis AR, Sunshine JH. Radiology at the turn of the millennium. Radiology. 2000;214(1):15-23. doi:10.1148/radiology.214.1.r00ja4515
  5. European Society of Radiology 2009 (2010)., Op cit.
  6. Ibid
  7. US Bureau of Labor Statistics. Radiologic technologists. Retrieved from https://www.bls.gov/ooh/healthcare/radiologic-technologists.htm#:~:text=Overall%20employment%20of%20radiologic%20and,a%20tool%20for%20making%20diagnoses.
  8. NHS Radiographer Job openings. Retrieved from https://www.jobs.nhs.uk/xi/search_vacancy/?action=search&staff_group=SG15&keyword=Radiography
  9. US Bureau of National Statistics. Physicians and Surgeons Salaries. Retrieved from https://www.bls.gov/ooh/healthcare/physicians-and-surgeons.htm
  10. NHS. Radiologist Vacancies. Retrieved from https://www.jobs.nhs.uk/xi/search_vacancy/
  11. Cozzi, D., Albanesi, M., Cavigli, E., Moroni, C., Bindi, A., Luvarà, S., Lucarini, S., Busoni, S., Mazzoni, L. N., & Miele, V. (2020). Chest X-ray in new Coronavirus Disease 2019 (COVID-19) infection: findings and correlation with clinical outcome. La Radiologia medica, 125(8), 730–737. https://doi.org/10.1007/s11547-020-01232-9
  12. European Society of Radiology 2009 (2010)., Op cit.

References

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