Radiology In Germany

Being a relatively young discipline, the birth of which can be considered the discovery of X-rays in 1895, radiology in Germany and other German-speaking countries is an integral part of the diagnosis and therapy of many diseases that are involved, like oncology, and many other medical specializations.

Modern German radiology is divided into components, depending on the organs being examined and the age of the patients. These include, for example, neuroradiology, which deals with the nervous system, mammography (research of female dairy glands), pediatric radiology, etc.
To the services of radiology, doctors resort to diagnosing about 80% of serious diseases. This is understandable, because in our time, it is thanks to the development of radiology that it is absolutely bloodless to get an intravital color three-dimensional image of any organ, a section of the vascular bed or the musculoskeletal system, and view it from any angle and from either side. Also, virtual sections of the structures mentioned above, at a thickness of 0.5 mm, can be provided to physicians. Needless to say, to what extent does this accuracy not only improve the quality of the diagnosis, but also, if necessary, simplify the planning of surgical interventions?

Of course, we can not fail to mention ultrasound - perhaps the only hardware diagnostic procedure that does not have any side effects. Today, thanks to the Doppler Sonography, it is possible not only to "examine" the internal organs and blood vessels, but also to determine the state of the blood flow in them, up to the primary determination of the sufficiency of the heart valves.

Somewhat apart, being, however, included in radiology, there is the so-called "nuclear medicine" (Nuklearmedizin) in Germany, which uses radiation for diagnostic and therapeutic purposes. This natural phenomenon was discovered by Henry Becquerel a year after Conrad opened X-rays, which were then named after him. Unlike x-rays, its practical application of radiation found only 24 years later, with the easy hand of chemist Georges de Hevesi. He used radioactive elements to label the food that the housewife gave him to check if she was giving him yesterday's leftovers the next day? "That's exactly what she did."

In our time, small doses of radioactive substances with a very short half-life are used to diagnose the state of metabolism and tumors. The technique is based on the accumulation or reduction of the amount of these substances in certain parts of the body. The first include, among others, tumors, and to the second the so-called "cold" nodes of the thyroid gland that carry the potential risk of malignancy.

The combination of methods of tomography and determination of the level of metabolism gave rise in the 1990s to PET or positron emission tomography, which gives much more accurate images than either method alone. Currently, PET refers to standard procedures not only in oncology, but also in the diagnosis of heart diseases (eg, myocardial infarction), Parkinson's disease, epilepsy and for setting a differential diagnosis between depression and dementia (dementia). It is also much earlier than other methods to determine the effectiveness of the therapy and, if necessary, make the necessary changes. Thus, PET has, as a minimum, very great importance for the individually developing individual approach to the treatment of each patient in Germany, which is the cornerstone of the new paradigm of Western medicine.

Along with diagnostics, radioactive substances are widely used in the treatment of many diseases. At the same time, for therapeutic purposes, ß-radiation is used, which can spread in the surrounding tissues only by millimeters and, therefore, does not represent practically no danger for the rest of the organism. So already from the forties of the twentieth century in the therapy of the thyroid gland is used radioactive iodine.

A relatively new area of application of radioactive drugs are radio-sinovorteses, which are isolated in a separate field of nuclear medicine and since 1993 are used in Germany for outpatient treatment of arthritis and rheumatism.

German radiology can rightfully be proud of another, which has received rapid development in recent years. This is an interventional radiology, which includes minimally invasive interventions to carry out literally acupressure surgical interventions. Such interventions are used very widely - from narrowed vessels to tumors. And, if we are already accustomed to shunting or stenting of the coronary vessels of the heart, elimination of stenosis (constriction) of the vessels of the big toe, for example, with diabetes mellitus, taking into account their minimum diameter, can quite delight even the experienced non-professionals. I would like to note that more recently, such a diagnosis often meant amputation, at least, a finger.

Treatment of tumors also reduces to the effect on the vessels, only here everything happens vice versa. Stenosis feeding the altered tissue of the vessels is created artificially. Through a small (from a few millimeters to 1 - 2 cm) incision, a catheter is inserted, moves on to the tumor and then microscopic balls, so-called embolizates, are introduced through it into the desired vessel. The tumor ceases to be supplied with blood and is replaced by a scar tissue. This is how the uterine myoma is treated today, which, although it does not, as a rule, present danger to life, can bring a woman a lot of suffering. Until recently, treatment consisted in the removal of this benign tumor, and with it, at best, the part of the uterus.

Another method is to coagulate the altered tissue, for example, with some liver tumors. At the same time directly probes through the skin are probed with a diameter of about 1.5 mm, which are at the same time radiators of radio or sv-frequencies. The waves radiated by them literally weld a new formation, as in a microwave oven. Since the hepatic tissue does not have painful nerve endings, the manipulation is practically painless for the patient. Only 15 minutes after the intervention, a control CT scan or MRI is performed, which allows to determine whether all pathological tissue has been destroyed. If not, repeated coagulation is carried out.

Almost as accurately as today, radiotherapy is carried out. For example, with tumors of the prostate, irradiation often helps to prevent urinary incontinence arising after surgical treatment and even preserve potency. The use of irradiation in tumors of the larynx often allows to keep the patient's voice almost unchanged. Surgical treatment in such cases leads, as a rule, to a complete loss of voice. In many cases, such as in breast tumors, when surgery is unavoidable, irradiation can significantly reduce the volume of tissue that is being removed and, thus, the operations that the doctors themselves used to call "crippling" cease to be so.

Due to the use of a computer and the improvement of CT and MRI techniques, the development of radiotherapy is confidently proceeding along the path of reducing and refining the field of application (we are talking about millimeters), which already now allows irradiating deeply located tumors with minimal harm to the surrounding healthy tissues, . To minimize the severity of complications in such cases.

The logical continuation of the trend is the so-called brachytherapy. This term refers to the location of a radiation source directly in the tumor tissue. This method is possible, for example, treatment of certain types of neoplasms of the prostate gland.

Thanks to the rapid development and introduction of the most advanced "non-medical" technologies into medical practice, already today more than half of the cancer diseases are curable or at least there is the possibility of achieving a stable and long-term normalization of the state (remission). Radiology in Germany occupies a worthy place among the most rapidly developing areas. Its successes, as parts of modern medicine, allow us to hope that many serious and even dangerous diseases will be very soon removed from the list of life threatening.