MR LIM Fang Keang is a bit of a private eye on the job.
The principal radiographer in the Department of Oncologic Imaging at the National Cancer Centre Singapore — a member of the SingHealth Group — uses sophisticated machines to detect tumours in a patient’s body.
Says Mr Lim: “It’s more than just pressing buttons.
“Before doing a scan, I’m like a detective. I must understand the patient’s condition and plan how to go about tracking the tumour.”
When doctors ask for a scan, he has to decide what technique to use to get the best image, as it helps the radiologist (a doctor who interprets the images) to make an accurate diagnosis.
However, getting good images can sometimes be challenging when a patient is in pain, unable to cooperate or keep still.
The procedure takes 30 to 45 minutes, with breaks in between each scan.
If a tumour is not readily detected in a suspected location, Mr Lim discusses with the radiologist whether to zoom in on a different area.
This is usually encountered when doing magnetic resonance imaging (MRI) of the spine.
Nothing to do with radios
Mr Lim, who has been a radiographer for 20 years, started his career by chance.
Previously an aviation technician, he saw a recruitment advertisement by the former School of Radiography and checked the dictionary to find out what the job was about.
“I realised that radiography had nothing to do with radios,” he recalls with a laugh.
Being a technology enthusiast, he was excited at the prospect of doing such a job. So after graduating, he joined the Singapore General Hospital, where he did x-rays for the first three years.
Later, he was trained to perform MRIs and computed tomography (CT) scans. He keeps up-to-date with the latest technology by attending seminars and reading books.
The final gatekeeper
Mr Lim says a good radiographer needs to be meticulous and mindful of a patient’s safety.
When doing an MRI, for instance, because of the powerful magnetic field, it is important to thoroughly screen patients for any implants they might have in their bodies.
If an implant in the body is not secured to a bone, it could get dislodged, causing harm to the patient. Other implants could heat up during a scan, resulting in burns.
He says: “Even though there are several levels of screening before the patient comes to us, we are the final gatekeepers.”
Mr Lim likes working with patients, many of whom ask for him at follow-up visits.
One of them is a patient with severe neck pain, who can only lie down for two minutes at a time.
To ease her discomfort, Mr Lim always moves the bed out from the machine in between scans to let her sit up, even though it prolongs the procedure.
Training and research
His work also involves training younger colleagues and students on attachment, as well as research.
He is currently working with radiologists on using MRI-guided, high-intensity ultrasound to identify and destroy cancer tissue in the prostate.
He says: “Research is crucial as it can provide new treatment options for patients in the future.”
Although his job is varied, what gives him the most satisfaction is “when a patient returns for a follow-up scan after treatment and there is no more cancer”.