Roger L. Cronk, DO, FACR
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1 Roger L. Cronk, DO, FACR President of X- Ray Associates of New Mexico American Osteopathic Board of Radiology, 1986 American Board of Radiology, 1980 CerHficate of Added QualificaHon (CAQ), in IntervenHonal Radiology, 1996 Choosing the Best Imaging Modality A. Available Imaging ModaliHes B. Strengths and LimitaHons of Each Modality C. Resources for SelecHng the Best Modality D. Insurance Criteria Benefit Management E. Imaging Quality 1
2 Imaging ModaliHes 1. Plain X- rays Film or Digital 2. Fluoroscopy 3. Ultrasound 4. Nuclear Medicine PET/CT 5. Computed Tomography 6. MagneHc Resonance Imaging 1. Plain X- rays A. O\en the First Choice Modality B. RelaHvely Low Cost C. Readily Available D. Nonspecific Findings E. Limited VisualizaHon of Many Organs 2
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4 1. Plain X- rays A. O\en the First Choice Modality B. RelaHvely Low Cost C. Readily Available D. Nonspecific Findings E. Limited VisualizaHon of Many Organs 4
5 2. Fluoroscopy A. Dynamic Imaging with X- rays B. LimitaHons of Contrast in Lumens & ResoluHon of Organs C. Cost and Availability Fluoroscopy Dynamic Imaging with X- rays 1. GI System 2. GU Systems 3. Vascular System 4. Other Mobile Structures 5
6 Fluoroscopy Dynamic Imaging with X- rays 1. GI System 2. GU Systems 3. Vascular System 4. Other Mobile Structures 6
7 Fluoroscopy Dynamic Imaging with X- rays 1. GI System 2. GU Systems 3. Vascular System 4. Other Mobile Structures 7
8 Fluoroscopy Dynamic Imaging with X- rays 1. GI System 2. GU Systems 3. Vascular System 4. Other Mobile Structures 8
9 2. Fluoroscopy A. Dynamic Imaging with X- rays B. LimitaHons of Contrast in Lumens & ResoluHon of Organs C. Cost and Availability 3. Ultrasound A. Excellent VisualizaHon of Solid Organs B. Dynamic Imaging of Organs & Vessels C. No RadiaHon D. PaHent Body Habitus E. Air Containing Structures & Bone F. Technologist Dependent 9
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11 3. Ultrasound A. Excellent VisualizaHon of Solid Organs B. Dynamic Imaging of Organs & Vessels C. No RadiaHon D. PaHent Body Habitus E. Air Containing Structures & Bone F. Technologist Dependent 11
12 3. Ultrasound A. Excellent VisualizaHon of Solid Organs B. Dynamic Imaging of Organs & Vessels C. No RadiaHon D. PaHent Body Habitus E. Air Containing Structures & Bone F. Technologist Dependent 4. Nuclear Medicine Imaging Gamma Camera & Positron Emission Tomography A. Physiologic Imagining B. SensiHvity C. May Lack Specificity D. Cost & RadiaHon E. Availability 12
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15 4. Nuclear Medicine Imaging Gamma Camera & Positron Emission Tomography A. Physiologic Imagining B. SensiHvity C. May Lack Specificity D. Cost & RadiaHon E. Availability 5. Computed Tomography A. Excellent Anatomic Detail A. SensiHve and Specific B. All Body Systems Able to be Imaged C. Has some Dynamic UHlizaHon D. Speed of Imaging E. RadiaHon & Cost 15
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18 5. Computed Tomography A. Excellent Anatomic Detail SensiHve and Specific B. All Body Systems Able to be Imaged C. Has some Dynamic UHlizaHon D. Speed of Imaging E. RadiaHon & Cost 18
19 6. MagneHc Resonance Imaging A. SensiHve & Specific for many Organs & Disease Processes B. StaHc & Dynamic Imaging C. Length of Exam & Confinement Can Be ProblemaHc D. Safety E. Availability & Cost 19
20 6. MagneHc Resonance Imaging A. SensiHve & Specific for many Organs & Disease Processes B. StaHc & Dynamic Imaging C. Length of Exam & Confinement Can Be ProblemaHc D. Safety E. Availability & Cost Resource For SelecHng the Best Modality A. The Radiologist as Consultant B. American College of Radiology Appropriateness Criteria C. Evaluate Cost/Benefit D. Internet 20
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24 Resource For SelecHng the Best Modality The Radiologist as Consultant American College of Radiology Appropriateness Criteria Evaluate Cost/Benefit Internet hdp:// Safety/Appropriateness- Criteria Scheduling Admin
25 PaHent Insurance Radiology Benefit Management Quality of Exam 1. PaHent 2. Modality 3. Technologist 4. Physician 25
26 Scheduling Admin Stephen Babel El Camino Imaging Center Heights MRI Alamogordo Imaging Center 26
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