The following are questions we are often asked about the various types of diagnostic imaging available. To schedule a service, call 215-938-5700.
Mammography, an x-ray of the breast, is used for breast screening. It can detect small calcifications that are often the first sign of breast cancer.
Breast tomosynthesis (commonly referred to as a 3D mammogram) may be used in conjunction with traditional digital mammography as part of your annual screening mammogram to capture more breast images. Unlike digital mammography, breast tomosynthesis:
- Uses high-powered computing to convert digital breast images into a stack of very thin layers or “slices”—building what is essentially a “3-dimensional mammogram”
- Has an X-ray arm sweep in a slight arc over the breast, taking multiple breast images in just seconds, producing a 3D image of the breast tissue
- Radiologists can now view the breast tissue a millimeter at a time, rather than viewing all the complexities of the breast tissue in a flat image
Ultrasounds use sound waves and their echoes to provide images of internal structures. Ultrasounds are used in certain circumstances where x-rays and radiation may be harmful, such as obstetrics.
ABUS (automated breast ultrasound system) is an FDA-approved breast cancer screening tool, designed specifically for women with dense breasts. It is performed in conjunction with a routine screening mammogram in patients with documented dense breasts and no history of abnormal mammograms. Women with masses or lumps causing pain should not receive ABUS.
ABUS helps doctors visualize cancers hidden in dense breast tissue, which may be missed by traditional screening mammograms. Having dense breast tissue can increase a woman’s risk of breast cancer up to 4-6 times compared to women without dense tissue.
Unlike traditional ultrasounds, ABUS allows both breasts to be screened in 15 minutes, creating hundreds of 3D images of the breast tissue to be reviewed by a radiologist. ABUS is not a replacement for mammography but an additional tool in detecting breast cancer as there are findings on mammography, such as fine calcifications, that cannot be seen on an ultrasound.
Like conventional MRI, open MRI uses magnets, radio waves and computer photographic techniques to obtain clear images of the body's internal structures. Unlike conventional MRI, however, open MRI allows patients to see and talk to imaging personnel - even hold hands with a loved one during the exam. Not all procedures can be performed in an open MRI, however. Consult your physician to see if the open MRI is right for you.
Breast MRI may be used in conjunction with mammography for patients with newly diagnosed breast cancer. It can exclude the presence of other hidden tumors, determine the extent of the known cancer and differentiate between post-operative scarring and recurrent disease. In addition, breast MRI evaluates implants for possible rupture or leakage and offers additional diagnostic information in the case of an inconclusive mammogram or ultrasound. A breast MRI may also be used as a screening tool in high risk patients, for example, those with genetic risk or a history of past radiation to the chest.
Stereotactic breast biopsy is a minimally invasive alternative to open surgical biopsy. The technique is most useful when mammography shows a mass that cannot be felt or a cluster of microcalcifications (tiny calcium deposits) that are closely grouped together.
During the 30- to 60-minute procedure, the woman lies prone on a special table with her breast projecting through an opening. A paddle-shaped instrument compresses the breast during the biopsy and a local anesthetic is administered. Next, a hollow needle is passed through the skin into the suspicious lesion. After the tissue samples are obtained, the skin opening is covered with a dressing. Patients should avoid strenuous activity for 24 hours after returning home. Most women report little or no pain and no scarring.
Computed Tomography (CT or CAT Scan) uses special x-ray equipment to provide highly detailed images of the internal organs. People with pacemakers or cardioverter defibrillators can safely undergo CT scanning.
PET measures the body's metabolic activity to produce three-dimensional images that help physicians differentiate between normal and abnormal tissue.
First, the patient is injected with a radioactive form of glucose (sugar) which is metabolized by the body. This substance emits signals which are picked up by the PET scanner. Next, a computer assembles these emissions into images. Cancer cells, for example, show up more brightly on the scan because they are more metabolically active. In cardiovascular or neurologic disorders, PET identifies problem areas by picking up indications of reduced metabolic activity.
Patients undergoing the PET scan receive the amount of radiation in approximately two chest x-rays.
Nuclear medicine is a specialized area of radiology that uses very small amounts of radioactive materials, or radiopharmaceuticals, to examine organ function and structure. This branch of radiology is often used to help diagnose and treat abnormalities very early in the progression of a disease, such as thyroid cancer. Some of the more common tests include renal, thyroid, bone, gallium, heart, brain, and breast cans.
A nuclear medicine scan consists of three phases: tracer (radionuclide) administration, taking images, and image interpretation. The amount of time between administration of the tracer and the taking of the images may range from a few moments to a few days, depending on the body tissue being examined and the tracer being used. Some scans are completed in minutes, while others may require the patient to return a few times over the course of several days.
Interventional radiologists use imaging techniques to perform percutaneous (through the skin) diagnostic and treatment procedures. Many of these therapeutic applications offer an alternative to open surgery and can even eliminate the need for hospitalization. Its many uses include angiography, which detects blood vessel blockages and angioplasty, a procedure which can eliminate these blockages and restore adequate blood flow; embolization or the insertion of a substance through a catheter to stop excessive bleeding; insertion of gastrostomy (stomach) tube or feeding tube for patients unable to take food by mouth; intravascular ultrasound, the use of ultrasound to image the inside of blood vessels; needle biopsies; insertion of blood clot filters which can catch blood clots and prevent them from traveling to the lungs; catheter insertions for chemotherapy, nutritional support or hemodialysis.