In conventional 2D mammography, overlapping tissue is a leading reason why small breast cancers may be missed and normal tissue may appear abnormal, leading to unnecessary callbacks. A 3D mammography exam includes a three-dimensional method of imaging that can greatly reduce the tissue overlap effect. During the 3D portion of the exam, an X-ray arm sweeps in a slight arc over the breast, taking multiple images. A computer then converts the images into a stack of thin layers, allowing the radiologist to review the breast tissue one layer at a time. A 3D mammography exam requires no additional compression and takes just a few seconds longer than a conventional 2D breast cancer screening exam. Large clinical studies in the U.S. and Europe have demonstrated the positive benefits of a Genius 3D Mammography™ exam. The largest study to date on breast cancer screening using the Genius exam was published in the Journal of the American Medical Association (JAMA).
OPEN BORE MRI
Magnetic Resonance Imaging (MRI) uses a strong magnetic field and radio waves to align the hydrogen atoms in the body to see internal organ and tissue images without the use of radiation. These images show the difference between normal and diseased tissue enabling physicians to diagnose abnormalities. MRI is a valuable tool to diagnosis conditions in the body including cancer, heart and vascular disease, stroke, breast disease, and joint and musculoskeletal disorders. Physicians use MRI scans to define anatomy and evaluate abnormalities related to head trauma, brain aneurysms and tumors, spinal cord trauma, glands and organs within the abdomen, and the structure of joints, soft tissues and bones. Patients with a pacemaker, aneurysm clips or metal implants cannot be scanned due to the strong magnetic pull associated with the MRI. Some patients may experience claustrophobic feelings when their head is positioned inside the MRI bore. However, with the new open bore design offering a spacious 70 cm (nearly 2.3 feet) opening, patients have more space between the body and the machine. That means more headroom, more legroom, more elbow room and more relaxation throughout the examination. Thanks to the short magnet, 60% of all applications can be done with the patient’s head outside the Open Bore. CT-like comfort married to true high-field power wasn’t possible before in any conventional Open system. For the first time, a very wide bore, a super short magnet, and the powerful performance of 1.5 Tesla field strength are combined to deliver an image quality not seen before in conventional Open MRI systems. The Siemens Magnetom Espree 1.5T offers the industry’s shortest magnet combined with the Tim (Total imaging matrix) technology removes the need for patient repositioning and coil changes. The stationary coils enable shorter exam times and much faster clinical routine. Now, obese and elderly to pediatric, even claustrophobic patients find its CT-like space to their liking. Because of the 1.5T strength, physicians can access clearer images than conventional Open MRI can provide.
COMPUTED TOMOGRAPHY (CT)
While CT uses X-ray technology, it is distinguished from other diagnostic imaging tools like traditional X-ray and MRI by its ability to display a combination of soft tissue (like muscles, tissue, organs and fat), bones and blood vessels all in a single image. Clinicians perform CT scans to diagnose kidney, lung, liver, spine, blood diseases, cancer, tumors and cysts, as well as blood clots, hemorrhages and infections.
Toshiba’s multi-slice technology captures precise images of the body’s rapidly moving organs like the heart and lungs, which appear blurry when scanned by a traditional CT. Multi-slice imaging also is especially useful for examining patients who are unable to hold their breath, like trauma victims, acutely ill patients and young children.
The fast scanning capabilities and unmatched image quality offer significant benefits for a quick and accurate diagnosis of trauma patients experiencing chest pain or stroke. Additionally, chest exams, which take 20-30 minutes with a standard CT scanner, can now be performed in just 19 seconds with images that allow physicians to see internal injuries and disease in greater detail than ever before.
Temple Imaging Center is one of a handful of U.S. healthcare facilities to offer a powerful new tool for diagnosing coronary artery disease without penetrating the skin.
The five-minute test – called calcium scoring – uses computed tomography (CT) scans (or CAT scans) to look for calcium deposits in the coronary arteries. Calcium is a component of arterial plaque, the fatty buildup that causes atherosclerosis by sticking to artery walls. When this plaque constricts blood flow it can lead to heart attacks. When it breaks loose and lodges elsewhere, it can trigger a stroke.
Temple Imaging Center clinicians are using the technique to measure the levels of calcium in a patient’s arteries – called a “calcium score.” A low calcium score indicates little risk of heart attack. A high score can be lifesaving by alerting cardiologists to the presence of heart disease and the need for further investigation.
The heart moves so quickly that it blurs images taken with traditional CTs. However, the CT used at CHI St. Luke's Health-Memorial can scan the entire heart in 10 seconds, giving radiologists and cardiologists clear pictures of the heart and its vessels in between beats. The calcium score is then determined with the use of specialized computer software.
The CT's detector features a highly efficient ceramic material that is able to reduce the overall radiation exposure to patients, as well as to hospital staff. The system’s dose control features provide up to a 40 percent total dose reduction for the patient to make exams as safe and comfortable as possible. The system also accommodates the scanning of both larger and taller patients with the ability to expand its field-of-view to accommodate specific patient sizes and clinical needs.
POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY (PET/CT)
PET/CT combines the imaging capabilities of a Positron Emission Tomography (PET) and a Computed Tomography (CT). Each tool helps physicians locate cancer within the body to determine treatment.
A PET scan is a highly sensitive nuclear medicine exam that detects metabolic signals of actively growing cancer cells. A CT scan provides the internal anatomical detail of the location, size and shape of abnormal cancerous growths. Alone, each imaging test has particular benefits and limitations, but when the two images are fused together, PET/CT provides complete information on cancer location and metabolism.
Patients are injected with FDG, a radioactive glucose tracer, about 45 minutes prior to the scan. The FDG is taken up in areas of the body that are metabolically active such as some organs and cancerous tumors. Both the PET and CT scans are performed at the same time. The PET/CT fusion creates a color image that allows physicians to see “hot spots” where cancer lives. Physicians can then determine the extent of cancer and treatment options.
Patients must be diagnosed with certain cancer indications prior to ordering PET/CT. These indications have guidelines and restrictions required to approve diagnosis, staging and restaging cancer.
Current indications approved by most insurance providers are:
- Solitary Pulmonary Nodule
- Non-Small-Cell Lung Cancer
- Breast Cancer
- Colorectal Cancer
- Esophageal Cancer
- Head and Neck Cancer
At least 24 hours prior to the scan, patients must follow a strict no sugar, low carbohydrate diet guideline in order for the test to be effective. Click here to learn more about the diet guidelines.
When PET/CT is used as a tool in cancer staging and restaging, statistics show the course of treatment is changed 30 percent of the time.
4D (or, real-time 3D) imaging technology allows patients to view a fetus and internal organs as if they were being held in the hands. Extraordinarily fast image acquisition and image processing allow true, instantaneous, real-time 4D imaging. The system’s powerful imaging capabilities support a variety of common exams, including vascular, thyroid, and testicular exams. It also offers advanced imaging capabilities specifically beneficial in the evaluation of breast masses.
The ultrasound system used at CHI St. Luke's Health-Memorial has the potential to:
- Make ultrasound exams much faster
- Help patients and their physician better visualize and understand their condition
- Help identify the nature of suspicious breast lesions sooner utilizing new, higher resolution, higher frequency transducers
- Enhance diagnostic capability, thus reducing or eliminating the need for more expensive or invasive tests and procedures
- Provide clearer ultrasound images, especially in difficult-to-image patients
- Guide catheters and needles in 3D space without radiation exposure
Because it can be used in the most delicate conditions without major side effects, ultrasound has become one of the most popular diagnostic methods among both patients and physicians. Ultrasound uses high-frequency sound waves to produce moving images of the body’s internal soft tissue structures. It provides a safe, fast and relatively painless means of diagnostic imaging on an outpatient basis.
According to the National Breast Cancer Foundation, Inc.®, breast cancer incidence in women has increased from 1 in 20 in 1960 to 1 in 8 today. If detected early, the five-year survival rate for this disease exceeds 95%1. MAMMOMAT NovationDR enables physicians and clinicians to better pinpoint disease and plan treatment. The system also meets the demands of modern mammography practices like CHI St. Luke's Health Memorial by providing digital screening, diagnosis, and stereotactic biopsy capabilities—all in one system. At 24 by 29 centimeters, the size of the MAMMOMAT NovationDRimage detector allows imaging of a wider range of patient breast sizes, and its new paddle design provides easier and more comfortable patient positioning. The system enables a direct conversion of X-ray to digital information and features MammoReportPlus, a multi-modality workstation for mammography with the ability to accept Computer Assisted Diagnosis (CAD) markers from approved vendors—which helps increase cancer detection rates. MammoReportPlus provides ultra-fast, high-volume mammogram reading, permitting users to switch between eight-view mammographic studies in less than one second—improving workflow in the process.
LOW DOSE CT FOR LUNG CANCER SCREENING
Lung cancer is the leading cause of cancer death and the second most common cancer among both men and women in the United States. However, screenings save lives. It is proven that cure rates for lung cancer increase significantly when detected early. CHI St. Luke’s Health-Memorial offers a low dose CT lung cancer screening for longtime smokers who have a higher risk for the disease.
To determine if you have a high risk of developing lung cancer, answer these 3 questions:
- Are you between the age of 55 and 77?
- Are you a current smoker or have you quit within the last 15 years?
- Do you have a cigarette smoking history of at least 1 pack per day for 30 years or 2 packs per day for 15 years?
If the answer is yes to all 3 questions, then you might benefit from a lung cancer screening. The screening is covered by Medicare, and a referral must come from your primary care physician.
Of course, the best way to lower your chances of lung cancer is to quit smoking. Talk to your doctor. If you have any questions, call the Temple Cancer Center at 936-639-7468.
A bone mineral density test, also known as a DEXA (dual-energy x-ray absorptiometry) scan, is a non-invasive and painless method to determine your bone health. The test measures how many grams of calcium and other bone mineral content are within a certain segment of bone. The higher your mineral content, the denser and stronger your bones are and less likely to break. Doctors use a bone density test to identify osteoporosis, determine your risk for fractures and monitor response to osteoporosis treatment.
Bone density is measured in the spine, wrist, and hip. These locations are the most likely to break because of osteoporosis.
The results from the scan will help your physician determine if medical supplements are necessary to increase your bone density.
Post-menopausal women over the age of 65 are recommended to have a bone density test.
The radiation exposure is minor (less than someone receives with a chest x-ray).
A Nuclear Medicine exam is a diagnostic procedure that uses a radioactive tracer substance and a special camera to image body and organ anatomy and function non-invasively. Tumors, infection and other disorders can be detected by evaluating organ function. Nuclear Medicine is used to:
- Analyze kidney function
- Image blood flow and function of the heart
- Scan lungs for respiratory and blood-flow problems
- Identify blockage of the gallbladder
- Evaluate bones for fracture, infection, arthritis or tumor
- Determine the presence or spread of cancer
- Identify bleeding into the bowel
- Locate the presence of infection
- Measure thyroid function to detect an overactive or underactive thyroid
Nuclear Medicine has become a very popular method of diagnosing and following coronary artery disease without the risk involved with cardiac catheterization. Nuclear medicine is the primary way metastatic bone disease is diagnosed.
Some scans require certain preparations prior to the appointment. Procedures involving evaluation of the stomach require the patient to arrive at the appointment with an empty stomach (NPO). Another procedure evaluating the kidneys requires the patient to drink plenty of water before the test. Your physician or the imaging center staff can give you preparation instructions for your exam.
DIAGNOSTIC RADIOLOGY – X-RAY
Diagnostic radiography, also known simply as x-ray, is the oldest, most frequently used form of medical imaging. It is widely used to identify healthy and abnormal conditions in the body. X-ray imaging is fast, easy and painless. It is useful in the diagnosis and treatment of bony and soft tissue injuries, infections, and fractures. Common x-ray exams are:
- Bone fracture, healing process or changes in bones
- Joint dislocation, fluid build up
- Injury or damage from infection, arthritis, abnormal bone growths or bone disease
- Chest to evaluate lungs, heart and chest wall
- Assist in detection and diagnosis of cancer
- Locate foreign object
X-ray imaging usually does not require any special preparation prior to exam.
DIAGNOSTIC RADIOLOGY – FLUOROSCOPY
Fluoroscopy uses a continuous x-ray beam to create a sequence of images that are digitally transmitted to a high-resolution TV monitor. The body part and its motion can be seen in “real time” detail.
Fluoroscopy enables physicians to look at many body systems, including the skeletal, digestive, urinary, respiratory, and reproductive systems. Fluoroscopy is used to evaluate specific areas of the body, including the bones, muscles and joints, as well as solid organs such as the heart, lung or kidneys. Examinations and procedures that use fluoroscopy along with preparations are:
- Intravenous Pyelogram (IVP) - You may be asked to take a mild laxative (in either pill or liquid form) the evening before the procedure. Drink extra fluids until midnight. Nothing to eat or drink from midnight until after test completed.
- Upper Gastrointestinal (GI) Tract series – Barium Swallow - You may be asked to take a mild laxative (in either pill or liquid form) the evening before the procedure. After midnight, you should not eat or drink anything.
- Lower Gastrointestinal (GI) Tract series – Barium Enema - You may be asked to take a mild laxative (in either pill or liquid form) and to use an over-the-counter enema preparation kit the evening before the exam and possibly a few hours before the procedure. Only clear liquids should be taken on the day before. After midnight, you should not eat or drink anything.
- Small Bowel series - You may be asked to take a mild laxative (in either pill or liquid form) the evening before the procedure. After midnight, you should not eat or drink anything.
- Arthrogram - Nothing to eat or drink for four hours prior to exam.
Always consult your physician on the detailed instructions to prepare for a test. Inform your physician of any medications you are taking and any allergies, especially to contrast materials. Some medications may be taken prior to an exam and others may negatively interact with your results.
Diagnostic radiography does involve some exposure to radiation. However, special care is taken during the exam to minimize exposure and maximize safety for the patient by using lead aprons or shields to block radiation when needed during the exam. The radiation dose for diagnostic radiography is about the same as the average person receives from everyday background radiation in about 10 days.