**Vahid Anwari, an X-Ray Technologist working in a large acute care hospital in downtown Toronto discusses his role in the healthcare team, as well as the exciting research opportunity in which he leads.**

X-ray technologists, also known as medical radiation technologists (MRTs) or radiographers, help in the diagnosis of diseases using X-ray images of the body. At my hospital, I work in the emergency department for the majority of my shifts. Prior to a procedure I communicate with other healthcare professionals and with patients to discuss the requested procedures, answering any questions or concerns they may have about their tests, then taking the X-rays of the patients. Sometimes, we have patients with acute injuries (bones fractures, internal injuries/bleeds) or suspected/undiagnosed diseases that require extra help during their imaging procedure to prevent unnecessary harm/injury and take the required imaging in the quickest time possible. If I am not working in the emergency department, I am paged to take X-rays in the operating room during procedures such as a hip replacements or spinal surgeries.

The operation of X-ray equipment requires lots of practice, technical and communication skills, to ensure the lowest radiation dose is used for the most optimal image. As the operator of the X-ray equipment, we are responsible for ensuring the safety of colleagues, ourselves and patients, by following a principle we call “as low as reasonable achievable (ALARA)”, meaning that we ensure the use of the lowest dose of radiation required for the required image.  Other departments that I work with include the Intensive Care Unit (ICU), that consists of patients who are in a critical condition often requiring repeated chest X-rays to monitor the progress of disease or the outcome of interventions. In all these settings, I play an integral role as a member of the inter-professional healthcare team that involves a dozen professions taking care of patients. The healthcare professionals that I interact with the most on a daily basis are nurses, and emergency room physicians. We work in collaboration with radiologists whom are the doctors that report the images we take. Other healthcare professionals that I interact with frequently are residents of different departments, surgeons, respiratory therapists, personal care assistants, and hospital porters.

The most common X-ray ordered in the emergency room is a 2-view chest X-ray. I usually take about 20-30 chest X-rays during my shift, depending on how busy we get. To take a proper X-ray, technologists must position patients in a specific way and operate the X-ray machine from a safe distance to reduce self-exposure to radiation. We protect patients from unnecessary X-ray radiation exposure by shielding them with lead aprons that block X-rays from passing through. To further reduce radiation exposure to patients, we practice using the lowest radiation doses possible to acquire images.

In addition to working in the clinical setting, I am involved in medical imaging research to optimize X-ray imaging, so that we are using the lowest radiation doses and getting the highest quality of images for accurate diagnosis of disease. This is one of the advantages of working at my hospital; we get to perform research that interests us. Prior to being tested in the clinical setting, we test new X-ray machines using phantoms, which are specifically designed objects that mimic the absorption of X-rays in the human body, thus allowing us to read, change, and improve radiation dose techniques prior to a clinical trial with actual patients. The project I am currently working on involves the testing and development of a new type of X-ray imaging device called digital tomography. This is an X-ray machine which takes several dozen images rather than one X-ray. In addition, I am involved in the development of a new phantom for imaging.

One of the most common questions I get asked by patients is about MRI and CT scans. Patients often get MRI and CT scans confused and are unsure which one uses radiation and which one is safe. CT scans use radiation to produce hundreds of highly detailed cross sectional images. MRI machines are essentially a large magnet; they do not use radiation and they rely on orienting magnetic spins of cells in the body to produce images. People often get asked if they could have an MRI instead of a CT scan, however this is often not possible because MRI images and CT scan show different things. MRI images take longer to produce, most scans take over 30 minutes, and if a doctor is looking for a bleed and time is critical, MRI scans are not used. In addition, during an MRI scan patients cannot have metal on or in their body as it will be attracted to the magnet inside the machine, therefore becoming dangerous to the patient and the staff. MRI technologists are highly trained to ensure patients are screened prior to being scanned to ensure metal is not present, including jewelry.