Frequently Asked Questions

FREQUENTLY ASKED QUESTIONS

What is Mammography?
 
Mammography, also known as a mammogram, is the examination of the breast using x- rays. Mammography is considered the most effective tool for early breast tumor detection. Most medical experts agree that successful treatment of breast cancer often is linked to early diagnosis. Mammography plays a central part in early detection of breast cancers because it can show changes in the breast up to two years before a patient or physician can feel them. Digital mammography allows the radiologist to alter the orientation, magnification, brightness and contrast to produce images of the breast that can be seen on a computer screen. Computer-aided detection (CAD) uses a digitized mammographic image to search for abnormal areas of density, mass or calcification that may indicate the presence of cancer. The CAD system highlights these areas on the images, alerting the need for further analysis.
How often should I have a mammogram?

Current guidelines from the U.S. Department of Health and Human Services (HHS), the American Cancer Society (ACS), the American Medical Association (AMA) and the American College of Radiology (ACR) recommend screening mammography every year for women, beginning at age 40. The National Cancer Institute (NCI) recommends that women who have had breast cancer and those who are at increased risk due to a genetic history of breast cancer should seek expert medical advice about whether they should begin screening before age 40 and about the frequency of screening.
When should I schedule my mammogram?

Before scheduling a mammogram, you should discuss problems in your breasts with your doctor. In addition, inform your doctor of hormone use, any prior surgeries and family or personal history of breast cancer. Generally, the best time is one week following your period. Do not schedule your mammogram for the week before your period if your breasts are usually tender during this time. Always inform your doctor or x-ray technologist if there is any possibility that you are pregnant.
How should I prepare for this procedure?

On the day of the exam do not wear lotion, deodorant or powder under your arms or on your breasts. Describe any problems you're experiencing with your breasts with your technologist. Remove all jewelry and clothing from the waist up - you will be given a gown that opens in the front.
What can I expect during the procedure?

To image your breast, an x-ray technician will position you near the machine and your breast will be placed on a platform and compressed with a paddle. Breast compression is necessary in order to:
  • Even out the breast thickness - so that all of the tissue can be visualized
  • Spread out the tissue - so that small abnormalities won't be obscured
  • Allow use of a lower x-ray dose
  • Hold the breast still - to eliminate blurring of the image caused by motion
  • Reduce x-ray scatter - to increase picture sharpness
The technologist will go behind a glass shield while making the x-ray exposure. You will be asked to change positions slightly between views. The process is repeated for the other breast. Routine views are a top-to-bottom and side view.
What will I experience during the procedure?

The exam takes about a half an hour. The technologist will apply compression on your breast and, as a result, you will feel pressure on the breast as it is squeezed by the compressor. Some women with sensitive breasts may experience some minor discomfort. Be sure to inform the technologist if pain occurs as compression is increased. If discomfort is significant, less compression will be used.

Magnetic Resonance Imaging (MRI)

What is MRI?

Magnetic resonance imaging (MRI), or nuclear magnetic resonance imaging (NMRI), provides great contrast between the different soft tissues of the body. This technique is especially useful in neurological (brain), musculoskeletal, cardiovascular, and oncological (cancer) imaging.
What are some common uses of MRI?

MRI is frequently used for imaging of the musculoskeletal system. MRI is often used to study the knee, ankle, foot, shoulder, elbow, wrist and hand. MRI is also a highly accurate method for evaluation of soft tissue structures such as tendons and ligaments, which are seen in great detail. Even subtle injuries are easily detected. In addition, MRI is used for the diagnosis of spinal problems including disc herniation, spinal stenosis and spinal tumors.
MRI is used for imaging of the heart. MRI of the heart, aorta, coronary arteries and blood vessels is a tool for diagnosing coronary artery disease and other heart problems. Doctors can examine the size and thickness of the chambers of the heart and determine the extent of damage caused by a heart attack or heart disease.

MRI is also used for imaging of cancer and functional disorders. Organs of the chest and abdomen such as the liver, lungs, kidney and other abdominal organs can be examined in great detail with MRI. This aids in the diagnosis and evaluation of tumors and functional disorders. In the early diagnosis of breast cancer, MRI is an alternative to traditional x- ray mammography. Furthermore because there no radiation exposure is involved, MRI is often used for examination of the male and female reproductive systems.
How should I prepare for this procedure?

Before your MRI exam, remove all accessories including hair pins, jewelry, eyeglasses, hearing aids, wigs and dentures. During the exam, these metal objects may interfere with the magnetic field, affecting the quality of the MRI images taken. Notify your technologist if you have:
  • any prosthetic joints - hip, knee
  • a heart pacemaker (or artificial heart valve), defibrillator or artificial heart value
  • an intrauterine device (IUD),
  • any metal plates, pins, screws or surgical staples in your body
  • tattoos and permanent make-up
  • a bullet or shrapnel in your body,
  • if you might be pregnant or suspect you may be pregnant
What should I expect during this procedure?

Depending on how many images are needed, the exam generally takes 15 to 45 minutes. However, very detailed studies may take longer. You must lie down on a sliding table and be comfortably positioned. Even though the technologist must leave the room, you 
will be able to communicate with them at any time using an intercom. You will be asked to remain still during the actual imaging process; however, between sequences, which last between 2-15 minutes, slight movement is allowed. Depending on the part of the body being examined, a contrast material may be used to enhance the visibility of certain tissues or blood vessels. A small needle is placed in your arm or hand vein and a saline solution IV drip will run through the intravenous line to prevent clotting. About two- thirds of the way through the exam, the contrast material is injected.
What will I experience during this procedure?
 
MRI is painless. Some claustrophobic patients may experience a "closed in" feeling. If this is a concern, a sedative may be administered. Also, newer open MRI machines have helped to alleviate this reaction. You will hear loud tapping or thumping during the exam. Earplugs or earphones may be provided to you. You may feel warmth in the area being examined. This is normal. If a contrast injection is needed, there may be some discomfort at the injection site. You may also feel a cool sensation at the site during the injection.
What will I experience during this procedure?
 
MRI is painless. Some claustrophobic patients may experience a "closed in" feeling. If this is a concern, a sedative may be administered. Also, newer open MRI machines have helped to alleviate this reaction. You will hear loud tapping or thumping during the exam. Earplugs or earphones may be provided to you. You may feel warmth in the area being examined. This is normal. If a contrast injection is needed, there may be some discomfort at the injection site. You may also feel a cool sensation at the site during the injection.

Digital X-ray

The Digital Diagnostic has revolutionized X-ray. This digital system produces outstanding diagnostic images quickly, using lower dosages of radiation that many conventional X-ray systems. This allows your doctor to make a faster, more confident diagnosis
What exactly is digital X-ray?
 
X rays are a form of radiation that can be focused into a beam. Unlike a beam of light, X-rays can pass through most objects including the human body. Unlike conventional X-rays that strike a piece of photographic film, our Phillips X-ray system uses a state of the art detector that processes and records images digitally. These images can then be viewed onscreen and archived on a computer by your doctor.

Dense tissues in the body such as bones, absorb many of the X-rays and appear white on a X-ray picture. Less dense tissues such as muscle and organs block fewer of the X-rays and will appear in shades of gray. You'll discover that digital X-ray testing is easy and much faster than conventional X-ray. It is designed to generate optimized X-ray images to help your doctor make a more confident diagnosis.
Why is Digital X-ray an important Diagnostic Tool?

Using our Philips Digital Diagnostic X-ray system it allows doctors to see detail about your bones and internal organs within seconds. Digital X-ray gives them this information more quickly and in many cases more economically than other tests. The other big advantage of the digital system is that it uses a very low dose of X-ray radiation. This is especially important for pediatric exams.
How Long Will the Exam Take?

Digital X-ray is much quicker than the older conventional X-ray technology in most cases the exam will only take a few minutes
Will there be discomfort?

Most people feel no discomfort during the exam. However the X-Ray table may feel hard or the room may feel chilly because air-conditioning is used to keep the X-ray equipment at a constant temperature. You may find the positions you need to hold are uncomfortable, especially if you have an injury.
How do you prepare for a Digital X-ray?

There is no special preparation required for most digital radiographs. Once you arrive, you may be asked to change into a gown before your exam. You will also be asked to remove any jewelry, eyeglasses and any mental objects that could obscure the images since those show up on X-rays and may block the bones. Women should always inform the doctor or X-ray tech if there is any possibility that they are pregnant
How is the procedure performed?

For the most part your general X-ray will be taken while you are lying on the table. Some examinations are performed sitting and others are done while standing. The technologist will give you certain instructions, such as holding your breath or holding still while the X-ray is being taken. Since digital images are seen within seconds, the technologist may review your images immediately.
Will I be alone?

You will be in constant contact with a technologist. Even when he or she is not in the C'X-ray room with you, you will be able to talk to him or her via an intercom.

Positron Emission Tomography (PET or PET/CT)

What is positron emission tomography?

Positron emission tomography (PET) is a nuclear medicine exam that produces a three dimensional image of functional processes in the body. A PET scan uses a small amount of a radioactive drug to show differences between healthy and diseased issue. The diagnostic images produced by PET are used to evaluate a variety of diseases.
What are some common uses of PET?
  • to detect cancer
  • to evaluate the heart for blood flow, signs of coronary artery disease or heart function
  • to evaluate the brain for memory disorders, brain tumors or seizure disorders
How should I prepare for this procedure?

PET is usually done on an outpatient basis. You should wear comfortable clothes. You will be instructed to not eat for four to six hours before your scan. Drink plenty of water prior to your exam. Consult with your doctor regarding the use of medications before the test.
What should I expect from this procedure?

You will receive an intravenous (IV) injection of the radioactive substance. However for some patients, you may be asked to inhale the substance. The radioactive substance will then take approximately 30 to 90 minutes to travel through your body and be absorbed by the tissue under study. During this time, you will be asked to rest quietly and avoid significant movement or talking, which may alter the localization of the administered substance. You will be positioned on the PET scanner table and be asked to lie still during your exam. Scanning takes 30 to 45 minutes. Some patients who are being evaluated for heart disease may undergo a stress test in which PET scans are obtained while they are at rest, and again after undergoing the administration of a pharmaceutical to alter the blood flow to the heart. Usually, there are no restrictions on daily routine after the test. You should drink plenty of fluids to flush the radioactive substance from your body.
What will I experience during the procedure?

If given an intravenous injection, you will feel like a slight prick. However, you will not feel the substance in your body. You will be made as comfortable as possible on the exam table before you are positioned in the PET scanner for the test. You will hear buzzing or clicking sounds during the exam. Patients who are claustrophobic may feel some anxiety while positioned in the scanner.

Fluoroscopy

What is fluoroscopy?

Fluoroscopy is an enhanced x-ray that makes a moving picture of internal organs. A constant stream of x -rays pass through the patient. This casts shadows of internal organs onto a screen. Doctors use fluoroscopy when they need to see internal movement.
What are some common uses of this procedure?

One use is to observe the lungs and diaphragm. The diaphragm is the muscle between the chest and the abdomen that controls breathing. Fluoroscopy shows whether it is moving properly. It can also show various parts of the digestive tract when used during a barium swallow or enema test. Contrast dyes allow views of the gall bladder, bile ducts, and pancreas. Finally, it may be used to guide the passage of catheters or other tools through the body.
What can I expect during this exam?

Fluoroscopic imaging is painless. Before the imaging you will need to remove any jewelry or clothing that are in the area being scanned. For Gl studies, you will usually need to drink barium, or have a barium enema. The barium provides the contrast needed to produce a clear image that can detect polyps and other abnormalities or obstructions.

You will then lie on a table or stand depending on the purpose and area being imaged. The camera will be moved to a position above or in front of you in order to get the proper angle for the images. The procedure will take anywhere from a few minutes to an hour depending on the purpose of the imaging. For example, fluoroscopy is often used in interventional radiology to aid the positioning of a needle for a biopsy or other procedure.

Nuclear Medicine

What is nuclear medicine?

Nuclear medicine, or scan, uses a small amount of a radioactive substance to produce two or three dimensional images of body anatomy and function. The diagnostic images produced by a nuclear scan are used to evaluate a variety of diseases. Sometimes a nuclear scan is combined with a CT scan.
What are some common uses of nuclear medicine?

Nuclear medicine images can assist the physician in viewing, monitoring or diagnosing:
  • tumors
  • blood flow and function of the heart
  • respiratory and blood-flow problems in the lungs 
  • organ funtction- of the kidney, bowel, gallbladder and others
How should I prepare for this procedure?
 
Usually, no special preparation is needed. However, if the exam is done to evaluate the stomach, you may be asked to refrain from eating immediately before the test. If the exam is done to evaluate the kidneys, you may need to drink plenty of water before the test.  
What can I expect during this procedure?
 
Although imaging time can vary, the exam generally takes 20 to 45 minutes. A radiopharmaceutical, known as a tracer, is usually administered either intravenously or by mouth. What radiopharmaceutical is used and when is dependent upon the type of exam you're having. For most nuclear scans, you will lie down on a table and a nuclear imaging camera will be used to capture the image of the area being examined. The camera is either suspended over or below the exam table or in a large donut-shaped machine similar to a CT scanner. While the images are being obtained, you must remain as still as possible. Most of the radioactivity is expelled out of your body in urine or stool. The rest simply disappears over time.
What will I experience during the procedure?

Although usually done with a small needle, some patients experience some minor discomfort from the intravenous injection or IV. Also, lying still on the examining table may be uncomfortable for some patients. You will hear low-level clicking or buzzing noises from the machine.

Ultrasound

What is ultrasound imaging?

Ultrasound imaging, also called sonography, is a method of obtaining diagnostic images from inside the human body through the use of high frequency sound waves. Utrasonography is used as a diagnostic tool that can assist doctors with making recommendations for further treatment.
What are some common uses of ultrasound?
  • Viewing an unborn fetus
  • Examining many of the body's internal organs, including the heart, liver, gallbladder, spleen, pancreas, kidneys and bladder
  • Show movement of internal tissues and organs; enable physicians to see blood flow and heart valve functions
  • Used to guide procedures such as needle biopsies
  • Image the breast and to guide biopsy of breast cancer
  • Evaluate superficial structures, such as the thyroid gland and scrotum (testicles)
How should I prepare for this procedure?

Wear comfortable, loose-fitting clothing. Depending on the type of ultrasound exam you have, you will be asked not to eat or drink for up to 12 hours before your appointment, or drink up to six glasses of water two hours prior to your exam and avoid urinating. This will ensure a full bladder when the exam begins.
What should I expect during this procedure?

The examination usually takes less than 30 minutes. After being positioned on the exam table, a clear gel is applied in the area being examined. This helps the transducer make contact with the skin. The technologist firmly presses the transducer against the skin and moves it back and forth to image the area of interest. Generally, the technologist is able to review the ultrasound images in real-time or, when the examination is complete and the gel is wiped off, you may be asked to dress and wait while the ultrasound images are reviewed, either on film or monitor.
What will I experience during the procedure?

Most ultrasound exams are painless. The gel applied to your skin may be a bit cold and there may be varying degrees of discomfort and pressure as the technologist guides the transducer over your abdomen, especially if you are required to have a full bladder.

Biopsy (CT and Ultrasound Guided)

What is ultrasound guided biopsy?

In addition to conventional diagnostic ultrasound, ultrasound also provides the ability to offer image guided biopsies into certain nodules or cysts. Using sterile technique with ultrasound guidance, a nodule can be further evaluated. A sample(s) of the nodule will be obtained when the nodule is solid or, in the case of a fluid filled cyst, fluid will be extracted from the nodule.
What is CT guided biopsy?

In addition to conventional diagnostic CT scans, CT also provides the ability to offer image guided biopsies into certain nodules or cysts. Using sterile technique with CT scan guidance, a nodule can be further evaluated. A sample (s) of the nodule will be obtained when the nodule is solid or, in the case of a fluid filled cyst, fluid will be extracted from the nodule.
What can I expect during this procedure?

The area will be anesthetized and a needle will be inserted through the surface of the skin into the area of concern. Multiple samples will be taken of the nodule and sent to a laboratory for analysis. If the nodule is fluid filled the fluid will be drained and also sent for analysis. Image guided biopsy offers the opportunity for a less invasive procedure from surgery with diagnostic results.

CT Scan

What is computed tomography?

Computed tomography (CT) uses x-ray and computer equipment to produce cross-sectional images of body tissues and organs. CT imaging is useful because it can show several types of tissue, such as lung, bone, soft tissue and blood vessels.
What are some common uses of CT?
  • Studying the chest and abdomen.
  • Diagnosing and treating spinal problems and injuries to the hands, feet and other skeletal structures. 
  • Diagnosing cancer. CT examinations are often used to plan and properly administer radiation treatments for tumors, guide biopsies and other minimally invasive procedures, plan surgery and determine surgical resectability.
  • Diagnosing and treating spinal problems and injuries to the hands, feet and other skeletal structures.
  • Measuring bone mineral density for the detection of osteoporosis.
  • Identifying injuries to the liver, spleen, kidneys or other internal organs.
  • Detecting, diagnosing and treating vascular diseases that can lead to stroke, kidney failure or even death.
How should I prepare for this procedure?

On the day of your exam, wear comfortable, loose-fitting clothing. Avoid clothing with zippers and snaps as metal objects can affect the image. Depending on the part of the body that is being scanned, you may also be asked to remove hair pins, jewelry, eyeglasses, hearing aids and any dentures. You may be asked not to eat or drink anything for one or more hours before the exam. Women should inform their doctor or x-ray tech 
if there is any possibility that they are pregnant.
What can I expect during this procedure?

A CT examination usually takes five minutes to half an hour. The technologist positions you on the CT table and pillows are used to help keep you still and in the proper position during the scan. The table will move slowly into the CT scanner opening. Depending on the area of the body being examined, the increments of movement may be very small and almost undetectable, or large enough to feel the motion. To enhance the visibility of certain tissues or blood vessels, use of different contrast materials may be required. Depending on the type of examination, contrast material may be injected through an IV, swallowed or administered by enema. Before administering the contrast material, you should inform the radiologist or technologist of the following:
  • Any allergies, especially to medications or iodine 
  • Whether you have a history of diabetes, asthma, kidney problems, heart or thyroid conditions. These conditions may indicate a higher risk of reaction to the contrast material or potential problems eliminating the material from the patient's system after the exam.
You will be alone in the room during your scan; however your technologist can see, hear and speak with you at all times. To determine if more images are needed, you may be asked to wait until the images are reviewed.
What will I experience during the procedure?

CT scanning is painless. Depending on the type of scan you are having, your preparation may differ. To enhance the visibility of body tissue or blood vessels, use of different contrast materials may be administered:
  • Mouth: You may be asked to swallow water or contrast material, a liquid that allows the radiologist to better see the stomach, small bowel and colon. Some patients find the taste of the contrast material slightly unpleasant, but tolerable.
  • Enema: For a study of the colon, your exam may require the administration of the contrast material by enema. You will experience a sense of abdominal fullness and may feel an increasing need to expel the liquid. The discomfort is generally mild.
  • IV injection: To accentuate the appearance between normal and abnormal tissue in organs like the liver and spleen and to better define the blood vessels and kidneys, a contrast material is commonly injected into a vein. You might feel:
    • Flushed or have a metallic taste in your mouth. These are common reactions which disappear in a minute or two.
    • A mild itching sensation. If the itching persists or is accompanied by hives, it can be easily treated with medication.
    • In very rare cases, you may experience shortness of breath or swelling in the throat or other parts of the body. These can be indications of a more serious reaction to the contrast material. Your technologist should be notified immediately.

MR Angiography

What is MR angiography?

Angiography is a minimally invasive medical test that helps physicians diagnose and treat medical conditions. Angiography in conjunction with magnetic resonance imaging (MRI) produces pictures of major blood vessels throughout the body. In magnetic resonance angiography (MRA), a powerful magnetic field, radio waves and a computer produce the detailed images. During an MRA exam, radio waves are directed at the area of your body being studied. In the magnetic field, protons in your body change their position, producing signals that are detected by the coils. A computer then processes the signals and generates a series of images each of which shows a thin slice of the body. The computer compiles the images into a three-dimensional representation of the body, which can be studied from many different angles on a computer monitor.
What are some common uses of the procedure?

MRA is used to examine blood vessels in key areas of the body. Physicians use the procedure to identify and detect diseases of the brain, kidneys, pelvis, legs, lungs, heart and neck.
How should I prepare for the procedure?

You may be asked to wear a gown during the exam or you may be allowed to wear your own clothing if it is loose-fitting and has no metal fasteners. Some examinations may require the patient to swallow contrast material or receive an injection of contrast. If you have claustrophobia or anxiety, you may want to ask your physician for a prescription for a mild sedative. Metal and electronic objects are not allowed in the exam room because they can interfere with the magnetic field. These items include jewelry, watches, credit cards, hearing aids, pins, hairpins, metal zippers, metallic items, removable dental work, pens, pocketknives and eyeglasses.
What can I expect during this procedure?

You will be positioned on the moveable examination table. Straps and bolsters may be used to help you stay still and maintain the correct position during imaging. Small devices that contain coils capable of sending and receiving radio waves may be placed around or adjacent to the area of the body being studied. Ifa contrast material will be used in the exam, an IV line will be inserted into a vein in your hand or arm. A saline solution will drip through the IV to prevent blockage of the IV line until the contrast material is injected. The contract material will be injected into the IV after an initial series of scans. When the contrast material is injected, it is normal to feel coolness and a flushing for a minute or two. Additional series of images will be taken following the injection, however, you will be able to relax between imaging sequences.
What is a DEXA scan?

To accurately detect osteoporosis, doctors commonly use DEXA bone densitometry to measure bone mineral density (BMD). DEXA is a quick, painless procedure for measuring bone loss. Measurement of the lower spine and hips are most often done.

DEXA Scan (Bone Densitometry)

What are some common uses of this procedure?

DEXA bone densitometry is commonly used to diagnose osteoporosis, a condition that often affects women after menopause, but may also be found in men. Osteoporosis involves a gradual loss of calcium, causing bones to thin, become more fragile and more likely to break.

The DEXA scan can also assess your risk for developing fractures and is effective in tracking the effects of treatment for osteoporosis and other conditions that can cause bone loss. Bone density testing is recommended for:
  • post-menopausal women age 60 or older who have risk factors for developing osteoporosis
  • patients with a personal or maternal history of hip fracture or smoking
  • post-menopausal women who are tall (over 5 feet 7 inches) or thin (less than 125 pounds)
  • men and women who have hyperparathyroidism
  • men and women who have taken medications that are know to cause bone loss for an extended period of time

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