OUTPATIENT RADIOLOGY CLINIC
SCOTT FERGUSON, MD
(870) 735-5555
Mammography
Mammography is a specific type of imaging that uses a low-dose x-ray system to examine breasts. A mammography exam, called a mammogram, is used to aid in the early detection and diagnosis of breast diseases in women.
An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.
Outpatient Radiology Clinic offers two distinct mammography systems:
Digital mammography, also called full-field digital mammography (FFDM), is a mammography system in which the x-ray film is replaced by solid-state detectors that convert x-rays into electrical signals. These detectors are similar to those found in digital cameras. The electrical signals are used to produce images of the breast that can be seen on a computer screen or printed on special film similar to conventional mammograms. From the patient's point of view, having a digital mammogram is essentially the same as having a conventional film mammogram.
Computer-aided detection (CAD) systems use a digitized mammographic image that can be obtained from either a conventional film mammogram or a digitally acquired mammogram. The computer software then searches 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 radiologist to the need for further analysis.
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Common Uses for the Procedure
Mammograms are used as a screening tool to detect early breast cancer in women experiencing no symptoms. It can also be used to detect and diagnose breast disease in women experiencing symptoms such as a lump, pain or nipple discharge.
Screening Mammography
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. 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. Research has shown that annual mammograms lead to early detection of breast cancers, when they are most curable and breast-conservation therapies are available.
The National Cancer Institute (NCI) adds 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.
Diagnostic Mammography
Diagnostic mammography is used to evaluate a patient with abnormal clinical findings such as a breast lump or lumps that have been found by the woman or her doctor. Diagnostic mammography may also be done after an abnormal screening mammogram in order to evaluate the area of concern on the screening exam.
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How to Prepare for Your Visit
Before scheduling a mammogram, the American Cancer Society (ACS) and other specialty organizations recommend that you discuss any new findings or problems in your breasts with your doctor. In addition, inform your doctor of any prior surgeries, hormone use, and family or personal history of breast cancer.
Do not schedule your mammogram for the week before your period if your breasts are usually tender during this time. The best time for a mammogram is one week following your period. Always inform your doctor or x-ray technologist if there is any possibility that you are pregnant.
The ACS also recommends you:
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Do not wear deodorant, talcum powder or lotion under your arms or on your breasts on the day of the exam. These can appear on the mammogram as calcium spots.
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Describe any breast symptoms or problems to the technologist performing the exam.
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If possible, obtain prior mammograms and make them available to the radiologist at the time of the current exam.
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Ask when your results will be available; do not assume the results are normal if you do not hear from your doctor or the mammography facility.
(Source: RadiologyInfo.org )
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Bone Density
Bone density scanning, also called dual-energy x-ray absorptiometry (DXA) or bone densitometry, is an enhanced form of x-ray technology that is used to measure bone loss. DXA is today's established standard for measuring bone mineral density (BMD).
An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.
DXA is most often performed on the lower spine and hips. In children and some adults, the whole body is sometimes scanned. Peripheral devices that use x-ray or ultrasound are sometimes used to screen for low bone mass. In some communities, a CT scan with special software can also be used to diagnose or monitor low bone mass (QCT). This is accurate but less commonly used than DXA scanning.
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Common Uses for the Procedure
DXA is most often used to diagnose osteoporosis, a condition that often affects women after menopause but may also be found in men and rarely in children. Osteoporosis involves a gradual loss of calcium, as well as structural changes, causing the bones to become thinner, more fragile and more likely to break.
DXA is also effective in tracking the effects of treatment for osteoporosis and other conditions that cause bone loss.
The DXA test can also assess an individual's risk for developing fractures. The risk of fracture is affected by age, body weight, history of prior fracture, family history of osteoporotic fractures and life style issues such as cigarette smoking and excessive alcohol consumption. These factors are taken into consideration when deciding if a patient needs therapy.
Bone density testing is strongly recommended if you:
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are a post-menopausal woman and not taking estrogen.
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have a personal or maternal history of hip fracture or smoking.
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are a post-menopausal woman who is tall (over 5 feet 7 inches) or thin (less than 125 pounds).
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are a man with clinical conditions associated with bone loss.
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use medications that are known to cause bone loss, including corticosteroids such as Prednisone, various anti-seizure medications such as Dilantin and certain barbiturates, or high-dose thyroid replacement drugs.
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have type 1 (formerly called juvenile or insulin-dependent) diabetes, liver disease, kidney disease or a family history of osteoporosis.
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have high bone turnover, which shows up in the form of excessive collagen in urine samples.
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have a thyroid condition, such as hyperthyroidism.
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have a parathyroid condition, such as hyperparathyroidism.
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have experienced a fracture after only mild trauma.
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have had x-ray evidence of vertebral fracture or other signs of osteoporosis.
The Lateral Vertebral Assessment (LVA), a low-dose x-ray examination of the spine to screen for vertebral fractures that is performed on the DXA machine, may be recommended for older patients, especially if:
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they have lost more than an inch of height.
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have unexplained back pain.
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if a DXA scan gives borderline readings.
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How to Prepare for Your Visit
On the day of the exam you may eat normally. You should not take calcium supplements for at least 24 hours before your exam.
You should wear loose, comfortable clothing, avoiding garments that have zippers, belts or buttons made of metal. Objects such as keys or wallets that would be in the area being scanned should be removed.
You may be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, removable dental appliances, eye glasses and any metal objects or clothing that might interfere with the x-ray images.
Inform your physician if you recently had a barium examination or have been injected with a contrast material for a computed tomography (CT) scan or radioisotope scan. You may have to wait 10 to 14 days before undergoing a DXA test.
Women should always inform their physician and x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby. Click here for more information from RadiologyInfo.org about pregnancy and x-rays.
(Source: RadiologyInfo.org )
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X-Ray
An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.
A bone x-ray makes images of any bone in the body, including the hand, wrist, arm, elbow, shoulder, spine, pelvis, hip, thigh, knee, leg (shin), ankle or foot.
The chest x-ray is the most commonly performed diagnostic x-ray examination. A chest x-ray produces images of the heart, lungs, airways, blood vessels and the bones of the spine and chest.
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Common Uses for the Procedure
A bone x-ray is used to:
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diagnose fractured bones or joint dislocation.
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demonstrate proper alignment and stabilization of bony fragments following treatment of a fracture.
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guide orthopedic surgery, such as spine repair/fusion, joint replacement and fracture reductions.
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look for injury, infection, arthritis, abnormal bone growths and bony changes seen in metabolic conditions.
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assist in the detection and diagnosis of bone cancer.
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locate foreign objects in soft tissues around or in bones.
The chest x-ray is performed to evaluate the lungs, heart and chest wall.
A chest x-ray is typically the first imaging test used to help diagnose symptoms such as:
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shortness of breath.
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a bad or persistent cough.
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chest pain or injury.
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fever.
Physicians use the examination to help diagnose or monitor treatment for conditions such as:
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pneumonia.
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heart failure and other heart problems.
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emphysema.
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lung cancer.
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line and tube placement.
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fluid or air collection around the lungs.
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other medical conditions.
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How to Prepare for Your Visit
Most x-rays require no special preparation.
You may be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, removable dental appliances, eye glasses and any metal objects or clothing that might interfere with the x-ray images.
Women should always inform their physician and x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby. Click here for more information from RadiologyInfo.org about pregnancy and x-rays.
(Source: RadiologyInfo.org )
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Ultrasound
Ultrasound is safe and painless, and produces pictures of the inside of the body using sound waves. Ultrasound imaging, also called ultrasound scanning or sonography, involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the probe through the gel into the body. The transducer collects the sounds that bounce back and a computer then uses those sound waves to create an image. Ultrasound examinations do not use ionizing radiation (as used in x-rays), thus there is no radiation exposure to the patient. Because ultrasound images are captured in real-time, they can show the structure and movement of the body's internal organs, as well as blood flowing through blood vessels.
Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions.
A Doppler ultrasound study may be part of an ultrasound examination. Doppler ultrasound is a special ultrasound technique that evaluates blood flow through a blood vessel, including the body's major arteries and veins in the abdomen, arms, legs, and neck.
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Common Uses for the Procedure
Ultrasound examinations can help to diagnose a variety of conditions and to assess organ damage following illness. Ultrasound is used to help physicians evaluate symptoms such as:
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pain
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swelling
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infection
Ultrasound is a useful way of examining many of the body's internal organs, including but not limited to the:
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heart and blood vessels, including the abdominal aorta and its major branches
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liver
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gallbladder
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spleen
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pancreas
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kidneys
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bladder
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uterus, ovaries, and unborn child (fetus) in pregnant patients
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eyes
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thyroid and parathyroid glands
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scrotum (testicles)
Ultrasound is also used to:
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guide procedures such as needle biopsies, in which needles are used to sample cells from an abnormal area for laboratory testing.
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image the breasts and guide biopsy of breast cancer (see the Ultrasound-Guided Breast Biopsy page.
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diagnose a variety of heart conditions, including valve problems and congestive heart failure, and to assess damage after a heart attack. Ultrasound of the heart is commonly called an "echocardiogram" or "echo" for short.
Doppler ultrasound images can help the physician to see and evaluate:
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blockages to blood flow (such as clots).
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narrowing of vessels.
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tumors and congenital vascular malformations.
The radiologist's interpretation of the speed and volume of blood flow gained from a Doppler ultrasound image may help the cardiologist determine whether a patient is a good candidate for a procedure like angioplasty.
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How to Prepare for Your Visit
You should wear comfortable, loose-fitting clothing for your ultrasound exam. You may need to remove all clothing and jewelry in the area to be examined.
You may be asked to wear a gown during the procedure.
Preparation for the procedure will depend on the type of examination you will have. For some scans your doctor may instruct you not to eat or drink for as many as 12 hours before your appointment. For others you may be asked to drink up to six glasses of water two hours prior to your exam and avoid urinating so that your bladder is full when the scan begins.
(Source: RadiologyInfo.org )
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Barium Enema
Lower gastrointestinal (GI) tract radiography, also called a lower GI or barium enema, is an x-ray examination of the large intestine, also known as the colon. This examination evaluates the right or ascending colon, the transverse colon, the left or descending colon, the sigmoid colon and the rectum. The appendix and a portion of the distal small intestine may also be included.
An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.
The lower GI uses a special form of x-ray called fluoroscopy and a contrast material called barium or a water soluble iodinated contrast.
Fluoroscopy makes it possible to see internal organs in motion. When the lower gastrointestinal tract is filled with barium, the radiologist is able to view and assess the anatomy and function of the rectum, colon and sometimes part of the lower small intestine.
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Common Uses for the Procedure
A physician may order a lower GI examination to detect:
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benign tumors (such as polyps)
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cancer
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ulcerative colitis (inflammatory bowel disease)
The procedure is frequently performed to help diagnose symptoms such as:
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chronic diarrhea
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blood in stools
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constipation
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irritable bowel syndrome
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unexplained weight loss
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a change in bowel habits
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suspected blood loss
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abdominal pain.
Images of the small bowel and colon are also used to diagnose inflammatory bowel disease, a group of disorders that includes Crohn's disease and ulcerative colitis.
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How to Prepare for Your Visit
The barium enema requested by your physician is an examination of your colon or large intestine. It can be very important in diagnosing disorders of the large intestine. It need not be difficult or particularly unpleasant. It does require great attention to detail.
IT IS ESSENTIAL THAT YOUR COLON BE THOROUGHLY CLEANSED FOR THIS EXAMINATION. EVEN A SMALL AMOUNT OF RETAINED STOOL MAY HIDE ABNORMALITIES. IN ADDITION, IF YOUR BOWEL IS COMPLETELY EMPTY, THE BARIUM ENEMA WILL BE LESS UNCOMFORTABLE FOR YOU.
The radiologists will perform the procedure with fluoroscopy and obtain a number of images using X-ray during the enema. The radiologist will write a consultation report of the findings for the physician.
Preparation Instructions:
Please follow a clear liquid diet the entire day before your exam. Clear liquids include:
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Clear juices without pulp (apple, white grape, lemonade, white cranberry)
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Water
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Clear broth or bouillon
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Coffee or tea (without milk or non dairy creamer)
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All of the following that are NOT RED OR PURPLE:
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Gatorade
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Carbonated and non-carbonated soft drinks (Sprite, 7-Up, ginger ale)
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Plain Jell-O (without added fruit or toppings)
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Ice popsicles
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Throughout the day, please make sure you drink plenty of liquids to prevent dehydration. The liquids are an important part of the preparation.
At 5:00 p.m. drink one (1) 10 ounce bottle of Magnesium Citrate; follow this with 8 ounces of clear liquids. Drink a minimum of three (3) additional 8 ounce glasses of clear liquids throughout the evening.
Day of the Examination:
Continue to follow a clear liquid diet. You may resume a normal diet AFTER your exam.
One and one half hours prior to leaving for your exam, please use one (1) Dulcolax suppository. This should result in a bowel movement within 30 minutes.
Bring a list of all your prescription medications, over-the-counter medications and herbal supplements --including frequency and dosage -- with you to your appointment.
Important: Please bring your physician's prescription and referral with you for the exam. If you have any questions about your exam, please call (870) 735-5555.
PRECAUTIONS:
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If you are a diabetic and require insulin, please contact your doctor before starting the preparation.
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If you have an inflammatory condition of the gastrointestinal tract, such as Chron's disease, regional enteritis or ulcerative colitis, you may want to discuss this preparation with your physician.
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If you have previously had an adverse response to any of the laxatives used in this preparation, please consult your physician for substitute laxative choices.
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If you suffer from severe or chronic diarrhea, you may want to discuss this preparation with your physician.
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This barium enema preparation is designed for use by the "average individual." If you have any doubts or concerns about your preparation, please do not hesitate to discuss them with your own physician. Additional questions may be directed to the radiologist.
(Source: RadiologyInfo.org, Princeton Radiology)
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Upper GI
Upper gastrointestinal tract radiography, also called an upper GI, is an x-ray examination of the esophagus, stomach and first part of the small intestine (also known as the duodenum). Images are produced using a special form of x-ray called fluoroscopy and an orally ingested contrast material such as barium.
An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.
Fluoroscopy makes it possible to see internal organs in motion. When the upper GI tract is coated with barium, the radiologist is able to view and assess the anatomy and function of the esophagus, stomach and duodenum.
An x-ray examination that evaluates only the pharynx and esophagus is called a barium swallow.
On occasion, some patients are given other forms of orally ingested contrast, usually containing iodine. These alternative contrast materials may be used if the patient has recently undergone surgery on the GI tract, or has allergies to other contrast materials. The radiologist will determine which type of contrast material will be used.
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Common Uses for the Procedure
An upper GI examination helps evaluate digestive function and can detect:
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ulcers
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tumors
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inflammation of the esophagus, stomach and duodenum
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hiatal hernias
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scarring
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blockages
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abnormalities of the muscular wall of GI tract
The procedure is also used to help diagnose the cause of symptoms such as:
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difficulty swallowing
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chest and abdominal pain
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reflux (a backward flow of partially digested food and digestive juices)
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unexplained vomiting
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severe indigestion
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blood in the stool (indicating internal GI bleeding)
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How to Prepare for Your Visit
Your physician will give you detailed instructions on how to prepare for your upper GI.
You should inform your physician of any medications being taken and if there are any allergies, especially to iodinated contrast materials. Also inform your doctor about recent illnesses or other medical conditions.
Women should always inform their physician and x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby. See the Safety page for more information about pregnancy and x-rays.
To ensure the best possible image quality, your stomach must be empty of food. Therefore, your doctor will likely ask you not to eat or drink anything (including any medications taken by mouth, especially antacids) and to refrain from chewing gum after midnight on the day of the examination.
You may be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, removable dental appliances, eye glasses and any metal objects or clothing that might interfere with the x-ray images.
(Source: RadiologyInfo.org)
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