Cyst Aspiration

Cysts are fluid filled sacs within the breast. These sacs form when normal milk-producing glands enlarge. The cause of this enlargement is not definitely known but is very likely related to an imbalance between the normal production and absorption of fluid. Breast cysts may be solitary but are most commonly multiple and can vary in size from microscopic to larger than a ping-pong ball. Breast cysts are common, particularly in women age 40-60. Although larger cysts can sometimes be felt as “lumps”, many cysts are undetectable by physical examination. LOCATIONS OFFERING Metairie – Veterans Boulevard Cysts are frequently seen as round masses on mammograms. When this occurs, breast ultrasound examination is usually performed. Breast ultrasound is the most sensitive and accurate method for the identification and diagnosis of breast cysts. With modern ultrasound equipment, accuracy rate of 95% to 100% can be expected. Virtually all breast cysts identified as “simple cysts” by ultrasound are benign and remain so. It is estimated that perhaps 1 in 1,000 cysts may harbor a tumor (not necessarily malignant). These can usually be identified by their ultrasound appearance. Women with cysts are not at greater risk for the development of cancer although this risk may be minimally elevated if there is a positive family history for breast cancer (mother, sister, daughter). Cyst aspiration is a a simple and effective technique which serves a dual purpose. It confirms the nature of the lump as “cystic” or “solid” and extracts fluid from a cyst which frequently makes the lump disappear. If no fluid is obtained, the lump is presumed not to be a cyst and whatever material is aspirated may be sent to the laboratory for analysis. When a cyst is discovered by ultrasound, aspiration is not generally recommended unless the cyst has some unusual features on the ultrasound image, or the cyst is associated with discomfort (physical or emotional) which can be relieved by aspiration. If the cyst appears to contain material other than fluid on the ultrasound image, an aspiration procedure may be recommended. This is best performed using ultrasound guidance to ensure complete drainage of the cyst.

Bone Scan

A nuclear medicine bone scan shows the effects of injury or disease (such as cancer) or infection on the bones. A nuclear medicine bone scan also shows whether there has been any improvement or deterioration in a bone abnormality after treatment. A radioactive material (radiopharmaceutical) is injected into a vein, attaches to the bones and is detected by a special camera (gamma camera) that takes images or pictures that show how the bones are working. Nuclear medicine bone scans are carried out for many different reasons. Bone scans image both the structure and the active cell growth of the bones, so are often used in conjunction with other imaging e.g. X-rays, computed tomography (CT) or magnetic resonance imaging (MRI). They are often used as a follow-up test when the cause of your pain or symptoms needs to be clarified, for example: to evaluate the source of bone pain; for example, foot or hip pain to evaluate the findings from other diagnostic images or abnormal laboratory results Listed below are some common reasons why your doctor may refer you for a bone scan: difficult to find fractures, stress fractures, shin splints osteomyelitis (infection of the bone), cellulitis (infection of the skin) or to assess a response to treatment (e.g. antibiotics) you might be having arthritis, Paget’s disease, fractures from osteoporosis (where bones become fragile and are more likely to break) to assess the presence or spread of cancer in bone, then to follow up on the response to treatment complex regional pain syndrome (CRPS or previously known as reflex sympathetic dystrophy), avascular necrosis, prosthesis loosening or infection. A bone scan helps your doctor evaluate how your bones are working, and provides information to help diagnose and treat your condition. It can show injury to the bones, the effects of disease such as cancer or infection, as well as any improvement or deterioration in a bone abnormality after any treatment you might be having.

Hysterosalpingogram

A Hysterosalpingogram (HSG) is usually done as part of an infertility evaluation for a woman of childbearing age. The radiologist introduces a speculum into the vaginal cavity to visualize the cervix. The cervix is cleaned with a Betadine preparation and then a thin catheter is inserted through the cervical canal into the endometrial cavity. The procedure can be used to investigate repeated miscarriages that result from congenital or acquired abnormalities of the uterus and to determine the presence and severity of these abnormalities, including: tumor masses adhesions uterine fibroids Hysterosalpingography is also used to evaluate the openness of the fallopian tubes, and to monitor the effects of tubal surgery, including: blockage of the fallopian tubes due to infection or scarring tubal ligation the closure of the fallopian tubes in a sterilization procedure and a sterilization reversal the re-opening of the fallopian tubes following a sterilization or disease-related blockage A small balloon at the end of the catheter is inflated in the endometrial cavity to provide a good seal. Under fluoroscopic observation, the radiologist injects a small amount of water-soluble contrast (15-20 cc), which fills the endometrial cavity of the uterus and both fallopian tubes. The tubal anatomy and patency can be assessed. Normally, the tubes are slender and spill freely into the peritoneal cavity. This exam must be performed between the 7th and 10th day of a woman’s menstrual cycle. Day one is the day menstruation begins. Women should also abstain from sexual intercourse from the onset of menstruation until the completion of the exam. Diagnostic Imaging Services also performs the Essure Confirmation Test. Essure is permanent birth control completed with a non-surgical procedure. The Essure Confirmation Test with a modified HSG is used to evaluate the location of the inserts and occlusion of the fallopian tubes. Every patient must have an Essure Confirmation Test three months following the Essure insert placement procedure. The patient must use alternative contraception (except an IUD or IUS) until the Essure Confirmation Test verifies satisfactory location and bilateral occlusion.

Ultra-Low Dose CT

Diagnostic Imaging Services was the first medical facility in the country to have the Hitachi Supria 16 Ultra Low Dose CT Scanner, which delivers the highest quality image at the lowest possible radiation dose. Its large bore opening offers a more spacious feeling for patients, and a higher table weight limit expands the range of people who can be imaged. One of the primary concerns for our patients is the radiation dosage that they will be subjected to upon receiving a CT scan. DIS offers an ultra-low dose solution to perform common tests that look for conditions such as brain, pulmonary, bone and cardiovascular complications. We use the latest technology of this 16-slice CT scanner to reduce the dosage and ensure the diagnostic scan is safer than even before. What is ultra-low dose radiation? Ultra-low dose medical radiation entails using the lowest amount of dosage to obtain a diagnostics study. There has been a large medical initiative to reduce dosages to the lowest levels possible while still maintaining the ability to detect early stage cancers. In addition to the even-further reduction of medical radiation used in a CT scan, another valuable benefit of our Supria technology is the comfort provided by the CT design. It has a larger opening, longer table and higher weight capacity, which all works in concert when scanning larger people. The Supria has an opening of 29.5″ (most traditional CT systems have 23.5″-27.5″ openings) and can accommodate people that weigh up to 500 pounds. For over four years, Diagnostic Imaging Services has created and implemented CT dose reduction practices at all of our centers. We have been supporters of the national Image Gently and Image Wisely campaigns that promote safety in medical imaging. The addition of the Supria 16 at our Women’s & Advanced Imaging Center in Metairie and our Covington Highway 21 facility is another important piece to that puzzle. Minimum exposure. Maximum image quality.

Stereotactic Breast Biopsy

Stereotactic breast biopsy uses mammography to help locate a breast lump or abnormality and remove a tissue sample for examination under a microscope. It’s less invasive than surgical biopsy, leaves little to no scarring and can be an excellent way to evaluate calcium deposits or tiny masses that are not visible on ultrasound. A breast biopsy is performed to remove some cells from a suspicious area in the breast and examine them under a microscope to determine a diagnosis. This can be performed surgically or, more commonly, by a radiologist using a less invasive procedure that involves a hollow needle and image-guidance. Image-guided needle biopsy is not designed to remove the entire lesion. In stereotactic breast biopsy, a special mammography machine uses x-rays to help guide the radiologist’s biopsy equipment to the site of the abnormal growth. Click here for a six minute overview of stereotactic breast biopsy. A stereotactic breast biopsy may be performed when a mammogram or an ultrasound shows a breast abnormality such as: a suspicious mass microcalcifications, a tiny cluster of small calcium deposits a distortion in the structure of the breast tissue an area of abnormal tissue change a new mass or area of calcium deposits is present at a previous surgery site. Stereotactic breast biopsy is a non-surgical method of assessing a breast abnormality. If the results show cancer cells, the surgeon can use this information for planning surgery. Procedure The DIS stereotactic breast biopsy system allows for women to either lie face down or be seated for the procedure. Determination will be made by the performing radiologist as to the position that will work best for obtaining tissue samples. In most cases, you will lie face down on a movable exam table and the affected breast will be positioned into an opening in the table. The table is raised and the procedure is then performed beneath it. If upright, you may be seated in front of the stereotactic mammography unit. The breast is compressed and held in position throughout the procedure. Preliminary stereotactic mammogram images are taken. A local anesthetic will be injected into the breast to numb it. A very small nick is made in the skin at the site where the biopsy needle is to be inserted. The radiologist then inserts the needle and advances it to the location of the abnormality using the mammogram and computer generated coordinates. Mammogram images are again obtained to confirm that the needle is within the lesion. Tissue samples are then removed. After the sampling, the needle will be removed. A final set of images will be taken. Once the biopsy is complete, pressure will be applied to stop any bleeding and the opening in the skin is covered with a dressing. No sutures are needed. This procedure is usually completed within one hour.

Galactography

Galactography uses mammography and an injection of contrast material to create pictures of the inside of the breast’s milk ducts. It is most commonly used when a woman has experienced a bloody or clear discharge from the breast nipple but has an otherwise normal mammogram. It’s important not to squeeze the nipple prior to the exam as there may only be a small amount of fluid and it is necessary to see where it is coming from to perform the exam. The most common use of galactography is to evaluate a woman who has a bloody or clear discharge from her breast nipple and an otherwise normal mammogram. Galactography is typically NOT called for in women with the following conditions: A discharge that is milky, blue-green, green, or gray is usually not a cause for concern, especially if it comes from multiple ducts in the breast. A discharge that is from both breasts in a woman who has not had children may indicate a side effect from a drug, or may be related to a pituitary problem located in the brain. In galactography, a small amount of contrast material is injected into the milk duct, and a mammogram is performed so that the inside of the milk duct can be seen. If there is a filling defect (black area) in the milk duct, it often indicates a small mass. Most of these are papillomas, which are non-cancerous masses of the milk ducts. They may be pre-cancerous, and sometimes are removed. Less than 10 percent of filling defects will be cancer. The galactogram will not only find the small mass, but will also show where it is located in the breast, to help the radiologist find the area. The patient is seated or placed on her back with the breast exposed. The nipple is cleansed, and a tiny amount of fluid is squeezed from the nipple to identify the duct with the discharge. The milk duct may be dilated to permit a small catheter (a plastic, hollow tube) or blunt-tipped tube to be inserted into the milk duct. Occasionally a warm towel will be placed on the breast to help the milk duct become more visible and to allow easier access to the milk duct. A small amount of contrast material is then injected, and a mammogram is obtained. A second injection and mammogram may be performed. You must hold very still and may be asked to keep from breathing for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image. The technologist will walk behind a wall or into the next room to activate the x-ray machine. When the examination is complete, you may be asked to wait until the radiologist determines that all the necessary images have been obtained. The procedure normally takes between 30 minutes and one hour. Galactography is performed at the DIS Women’s & Advanced Imaging Center in Metairie.

Gastric Emptying

A gastric emptying scan, also known as a gastric emptying study or test, is an exam that uses nuclear medicine to determine how fast food leaves the stomach. It differs from a standard X-ray in that it uses a small amount of radioactive material to emit photon energy. The energy is detected by a gamma camera, which creates a computerized image. Gastric emptying scans are often used to diagnose gastroparesis, a condition in which the stomach’s muscles don’t work properly. This results in a delay in sending food to the small intestine. Doctors order the scans for adults and children who frequently vomit, feel bloated after eating, or complain of abdominal pain. Weight loss or changes in sugar levels are also symptoms of gastroparesis.

HIDA Scan

A hepatobiliary (HIDA) scan is an imaging procedure used to diagnose problems in the liver, gallbladder and bile ducts. In the HIDA scan, a radioactive chemical or tracer is injected into a vein in your arm. The tracer is handled by the liver like bile. Bile is a fluid produced and excreted by your liver that helps your digestive system break down fats in the foods you eat. Bile is stored in your gallbladder and the gallbladder releases the bile when you eat a meal. A HIDA scan is most often done to evaluate your gallbladder. It’s also used to look at the bile-excreting function of your liver and to track the flow of bile from your liver into your small intestine. A HIDA scan images liver function, which complements images of body structure (anatomy) provided by X-ray and ultrasound. A HIDA scan may help in the diagnosis of several diseases and conditions, such as: Gallbladder inflammation (cholecystitis) Bile duct obstruction Congenital abnormalities in the bile ducts, such as biliary atresia Postoperative complications, such as bile leaks and fistulas Assessment of liver transplant Your doctor may use a HIDA scan as part of a test to measure the rate at which bile is released from your gallbladder (gallbladder ejection fraction).

OctreoScan

Octreoscan is used to visualize hormone-producing tumors of the nervous and endocrine systems, or neuroendocrine tumors. Most tumors of this nature contain cells with a receptor for the hormone somatostatin. In octreoscan, octreotide, an analogue of somatostatin, is labeled with a radioactive tracer and injected intravenously; the radioactive octreotide attaches to somatostatin receptors on the tumor cells and can then be observed with a special scanning camera. A variation of nuclear scanning, called single-photon emission computed tomography, or SPECT, enhances the sensitivity of the test. An OctreoScan may be ordered for the following purposes: To identify and pinpoint the location of benign or malignant (cancerous) neuroendocrine tumors (such as carcinoid tumors, small cell lung cancer, pituitary adenoma, neuroblastoma, medullary thyroid carcinoma and islet cell tumor of pancreas) prior to their surgical removal; this test can identify both primary cancer and cancer that has metastasized (spread) from other locations To monitor the effectiveness of therapy for neuroendocrine tumors and to detect recurrences or progression of disease

Small Bowel Follow Through

In Upper Gastrointestinal Series and Barium Swallow, the patient swallows the barium, which then lines or “paints” the walls of the structures desired. The gas crystals are used to create air and help distend the structures to allow more precise images.

Barium Swallow

These tests require two different densities of barium drinks and effervescent granules, taken with a small amount of water. The radiodense barium allows the examination of the function and the anatomical lining of the esophagus, stomach and proximal small intestine, also known as the duodenum. A barium swallow study is a variant of the UGI in which the patient’s swallowing mechanism, pharynx, and esophagus are the focus of the study. A small bowel follow-through is a continuation of a UGI whereby the entire small bowel is examined.

Mammography

A mammogram is an x-ray picture of the breast. It can be used to check for breast cancer in women who have no signs or symptoms of the disease. It can also be used if you have a lump or other sign of breast cancer. Screening mammography is the type of mammogram that checks you when you have no symptoms. It can help reduce the number of deaths from breast cancer among women ages 40 to 70. But it can also have drawbacks. Mammograms can sometimes find something that looks abnormal but isn’t cancer. This leads to further testing and can cause you anxiety. Sometimes mammograms can miss cancer when it is there. It also exposes you to radiation. You should talk to your doctor about the benefits and drawbacks of mammograms. Together, you can decide when to start and how often to have a mammogram. Mammograms are also recommended for younger women who have symptoms of breast cancer or who have a high risk of the disease. When you have a mammogram, you stand in front of an x-ray machine. The person who takes the x-rays places your breast between two plastic plates. The plates press your breast and make it flat. This may be uncomfortable, but it helps get a clear picture. A mammogram is an important step in taking care of yourself and your breasts. Whether you’re a mammogram newbie or a veteran, knowing what to expect may help the process go more smoothly. There are two types of mammograms: screening and diagnostic. Click here to learn more about the differences between the two. According to the American Cancer Society (ACS), here are tips to follow when preparing for a mammogram: If you have a choice, use a facility that specializes in mammograms and does many mammograms a day. Try to go to the same facility every time so that your mammograms can easily be compared from year to year. If you’re going to a facility for the first time, bring a list of the places and dates of mammograms, biopsies, or other breast treatments you’ve had before. If you’ve had mammograms at another facility, try to get those records to bring with you to the new facility (or have them sent there) so the old pictures can be compared to the new ones. Schedule your mammogram when your breasts are not tender or swollen to help reduce discomfort and get good pictures. Try to avoid the week just before your period. On the day of the exam, don’t wear deodorant or antiperspirant. Some of these contain substances that can show up on the x-ray as white spots. If you’re not going home afterwards, you may want to take your deodorant with you to put on after your exam. You might find it easier to wear a skirt or pants, so that you’ll only need to remove your top and bra for the mammogram. Discuss any new findings or problems in your breasts with your health care provider before getting the mammogram. We at Diagnostic Imaging Services understand the anxiety and stress that can be felt when preparing to undergo a mammogram. However, according to the ACS, only 2 to 4 screening mammograms in 1,000 lead to a diagnosis of breast cancer. DIS performs both conventional 2D digital mammography and Genius 3D mammography, also known as breast tomosynthesis. We offer convenient Saturday morning screening mammogram appointments at our Metairie – Veterans Memorial Boulevard center.

Liver Elastography

Diffuse liver disease is one of the major health problems in the world. It can result from many causes, including viral hepatitis (Hepatitis B or Hepatitis C), non-alcoholic or alcoholic fatty liver disease, autoimmune hepatitis, drug-induced liver injury, primary biliary cirrhosis, and several other less frequent etiologies. It is estimated that 360 million and 180 million people worldwide are infected with viral hepatitis B and C respectively. Between 500,000 and 700,000 people die annually as a result of Hepatitis B virus infection, and more than 350,000 people are estimated to die each year from Hepatitis C-related liver disease. Chronic liver damage results in hepatic fibrosis, characterized by an increase in extracellular matrix material produced by fibroblast-like cells. This process results in liver fibrosis that can progress to cirrhosis with distortion of normal liver architecture and portal hypertension. According to the Society of Radiologists in Ultrasound (SRU) consensus, in select patients, elastography may eliminate the need for liver biopsy for staging fibrosis. Accurately staging the degree of liver fibrosis is extremely important to determine if antiviral therapy is appropriate, and to predict treatment outcome and malignant potential. With current drug therapy, early stage fibrosis may be reversible. The histologic evaluation of liver biopsies is carried out using scoring systems that produce values for various categories of inflammation (grade), and fibrosis (stage). There are several scoring systems, all categorizing similar features. In the assessment of chronic Hepatitis C Virus (HCV), the most reproducible scoring system is the Metavir. On the Metavir scoring system, liver fibrosis is evaluated semi-quantitatively and staged on a five-point scale from 0 to 4 (F0: absent; F1: enlarged fibrotic portal tract; F2: peri-portal or initial portal-portal septa but intact architecture; F3: architectural distortion but no obvious cirrhosis; and F4: cirrhosis). The gold standard for diagnosis and staging of liver fibrosis has been liver biopsy. In addition to being an invasive procedure with potential complications of bleeding and severe pain, biopsy sampling error is an intrinsic problem due to the small sample size in a heterogeneous process.

Urography

Computed tomography (CT) urography use CT images after intravenous contrast material to obtain images of the urinary tract. CT urography (CTU) is used as primary imaging techniques the evaluation of hematuria, which is blood in the urine, to follow patients with prior history of cancers of the urinary collecting system and to identify abnormalities in patients with recurrent urinary tract infections. Urography images are used to evaluate issues or detect abnormalities in portions of the urinary tract, including the kidneys, bladder and ureters, including: Hematuria (blood in urine) Kidney or bladder stones Cancers of the urinary tract In addition to imaging the urinary tract, CT urography can provide valuable information about other abdominal and pelvic structures and diseases that may affect them.

Neuroimaging

Neuroimaging is a branch of medical imaging that focuses on the brain. Current neuroimaging techniques reveal both form and function. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are popular modalities utilized by medical professionals and radiologists to study the form of the brain and its related areas. These related areas include the: Cervical spine Thoracic spine Lumbar spine Head Temporal bone Orbits Neck Multiple Cavernomas SWI right T2 left MRI can be performed with advanced specialty protocols that are specific to such concerns as Multiple Sclerosis (MS) and Traumatic Brain Injury (TBI). MRI is one of the most sensitive diagnostic tools for the detection and monitoring of MS lesions. A technique called Susceptibility Weighted Imaging (SWI) has continued to develop into a powerful clinical tool to visualize venous structures and iron in the brain, and to study diverse pathologic conditions. SWI has been found to provide additional clinically useful information that is often complementary to conventional MRI sequences used in the evaluation of various neurologic disorders. One such MRI specialty neuroimaging study offered at Diagnostic Imaging Services is called NeuroQuant. NeuroQuant segments and measures volumes of the hippocampus, ventricles and other brain structures and compares the volumes to norms, based on the patient’s age, gender and intracranial volume. This information helps providers assess neurological conditions and neurodegenerative diseases such as Alzheimer’s disease and Epilepsy. This quantitative component provides statistically valid results back to the medical provider, taking the guesswork out of the diagnostic process. When it is considered necessary to examine the function of the brain via nuclear medicine, DIS offers another specialty neuroimaging study called CereScan. Nuclear medicine can prove to be invaluable in providing an overall picture of how the brain is working – or not working. Using a SPECT (Single Photon Emission Computed Tomography) camera in combination with advanced image processing software, CereScan’s functional brain evaluations focus on identifying the biological causes of brain disorders. Quantitative SPECT images measure up to 160 individual regions of the brain. People that receive recommendations from their medical provider for these types of specialty neurological imaging exams no longer have to be limited to going to the hospital. Diagnostic Imaging Services has continued its commitment to the latest in advanced radiology studies that are often demanded by physician subspecialists. From ultra-high field MRI and ultra-low dose CT to radiology specialists in neuroradiology and MRI, DIS is the leader in independent outpatient neuroimaging in southeast Louisiana.

Prostate 3T MRI

A cutting-edge prostate digital imaging system was incorporated with a leading-edge 3 Tesla (3T) magnetic resonance imaging (MRI) system at our independent outpatient imaging center in Metairie, LA. The result was the creation of an advanced prostate MRI program that is truly unique to the greater New Orleans area, state of Louisiana and the Gulf Coast. According to the American Cancer Society, prostate cancer is the most common cancer, other than skin cancer, in American men. Prostate cancer is the second leading cause of cancer death in men behind lung cancer. One man in 6 will be diagnosed with prostate cancer during his lifetime, compared to one out of 8 women developing breast cancer. The public’s understanding of the disease is increasing, including its prevalence, approaches to screening and prevention, treatment options and resources that offer updated prostate cancer information throughout the year. Prostate 3T MRI is a noninvasive imaging technique that does not utilize exposure to ionizing radiation. This MRI study uses a contrast agent, or dye, that is vital to the exam. Computer Aided Detection (CAD) is used to help the DIS radiologist identify lesions suspicious for prostate cancer. Rather than undergo repeat biopsies, the MRI reveals any potential concerns, thereby providing doctors with a way to either avoid further biopsies or perform a more precise, pinpoint one. MRI is an emerging tool for early imaging of prostate cancer and other prostate-related conditions. A major benefit for men choosing Diagnostic Imaging Services for a prostate 3T MRI exam is that they will not be subject to the use of an endorectal coil. Their overall experience is even more comfortable without an instrument being placed inside their rectum. Diagnostic Imaging Services has been added to the US 3T Prostate MRI Facilities as tracked by the Prostate Cancer Research Institute (PCRI). DIS is the only center in the state of Louisiana included in this directory. The directory functions as a resource for men, their families and their health care providers to identify imaging centers who perform this specialized MRI study. DIS recommends consulting with your urologist, primary care physician or primary health care provider if you believe that you may benefit from prostate MRI.

Arthrogram

An arthrogram is an x-ray study of the joints, usually performed in the shoulder, knees, etc. This exam is mainly done to see if you have tears or rips in the various connective tissues that help make up a well-working joint. The radiologist will start the procedure by cleaning the skin over the joint in order to prepare a sterile field for the exam. Then, Lidocaine or a similar medicine is used to numb the skin over the joint. Next, a small needle is injected into the joint and a series of films, using both fluoroscopy and plain x-rays, will be taken. Arthrogram The procedure is most often used to identify abnormalities within the: shoulder elbow wrist hip knee ankle The procedure is also used to help diagnose persistent, unexplained joint pain or discomfort. In some cases, local anesthetic medications or steroids may be injected into the joint along with the contrast material. These medications may temporarily decrease joint-related pain or inflammation and provide physicians additional information about possible sources of joint pain. Other than the restrictions that your physician has advised, you will not need to take any additional safety precautions, other than to be very careful and cautious in moving the joint that has been studied.

PET/CT

PET/CT combines two imaging technologies to provide information about the location and metabolism of cancer cells to aid in diagnosis and treatment. PET, or Positron Emission Tomography, detects the metabolic signals given off by cancer cells growing in the body. PET is a specialized radiology procedure used to examine various body tissues to identify certain conditions. PET may also be used to follow the progress of the treatment of certain conditions. While PET is most commonly used in the fields of neurology, oncology, and cardiology, applications in other fields are currently being studied. PET is a type of nuclear medicine procedure. This means that a tiny amount of a radioactive substance, called a radionuclide (radiopharmaceutical or radioactive tracer), is used during the procedure to assist in the examination of the tissue under study. Specifically, PET studies evaluate the metabolism of a particular organ or tissue, so that information about the physiology (functionality) and anatomy (structure) of the organ or tissue is evaluated, as well as its biochemical properties. Thus, PET may detect biochemical changes in an organ or tissue that can identify the onset of a disease process before anatomical changes related to the disease can be seen with other imaging processes, such as computed tomography (CT). The precise location of the cancerous cells, known as lesions or tumors, are then located with CT technology. A CT scan directs a series of x-ray pulses through the body. Each x-ray pulse lasts only a fraction of a second and represents a “slice” of the organ or area being studied. The slices or pictures are recorded on a computer and can be saved for further study. Nuclear medicine, or radionuclide, diagnostic imaging procedures are noninvasive and, with the exception of intravenous injections, are usually painless medical tests that help physicians diagnose and evaluate medical conditions. These imaging scans use radioactive materials called radiopharmaceuticals or radiotracers. Depending on the type of nuclear medicine exam, the radiotracer is either injected into the body, swallowed or inhaled as a gas and eventually accumulates in the organ or area of the body being examined. Radioactive emissions from the radiotracer are detected by a special camera or imaging device that produces pictures and detailed molecular information. Diagnostic Imaging Services performs PET/CT scans for these common medical reasons: Differentiate malignant from non-malignant disease (diagnosis) Determine whether a cancer has spread in the body (staging) Assess the effectiveness of a treatment plan, such as cancer therapy (response to therapy) Determine if a cancer has returned after treatment (restaging)

Ultrasound – Venous

Venous ultrasound provides pictures of the veins throughout the body. A Doppler ultrasound study may be part of a venous ultrasound examination. The most common reason for a venous ultrasound exam is to search for blood clots, especially in the veins of the leg. This condition is often referred to as deep vein thrombosis or DVT. These clots may break off and pass into the lungs, where they can cause a dangerous condition called pulmonary embolism. If the blood clot in the leg is found early enough, treatment can be started to prevent it from passing to the lung. A venous ultrasound study is also performed to: determine the cause of long-standing leg swelling. In people with a common condition called “varicose veins”, the valves that keep blood flowing back to the heart in the right direction may be damaged, and venous ultrasound can help the radiologist decide how best to deal with this condition. aid in the placement of a needle or catheter into a vein. Sonography can help locate the exact site of the vein and avoid complications, such as bleeding or damage to a nearby nerve or artery. map out the veins in the leg or arm so that pieces of vein may be removed and used to bypass a narrowed or blocked blood vessel. An example is using pieces of vein from the leg to surgically bypass narrowed heart (coronary) arteries. examine a blood vessel graft used for dialysis if it is not working as expected; for example, the graft may be narrowed or blocked.

Ultrasound – Vascular

Vascular ultrasound provides pictures of the body’s veins and arteries. A Doppler ultrasound study is usually part of a vascular ultrasound examination. Vascular ultrasound is performed to: help monitor the blood flow to organs and tissues throughout the body locate and identify blockages (stenosis) and abnormalities like plaque or emboli and help plan for their effective treatment detect blood clots (deep venous thrombosis (DVT) in the major veins of the legs or arms determine whether a patient is a good candidate for a procedure such as angioplasty evaluate the success of procedures that graft or bypass blood vessels determine if there is an enlarged artery (aneurysm) determine the source and severity of varicose veins

Ultrasound – Thyroid

An ultrasound of the thyroid produces pictures of the thyroid gland and the adjacent structures in the neck. It is one of nine endocrine glands located throughout the body that make and send hormones into the bloodstream. The thyroid gland is located in front of the neck just above the collar bones and is shaped like a butterfly, with one lobe on either side of the neck connected by a narrow band of tissue. The thyroid gland makes the thyroid hormone, which helps to regulate a variety of body functions including how fast the heart beats. It is very common for patchy areas or nodules to develop in the thyroid that may or may not be felt on the skin surface. About five to 10 percent of adults will have lumps in their thyroid that a doctor can identify on an exam. These are called palpable nodules. Ultrasound is very sensitive and shows many nodules that cannot be felt. In some age groups, nodules are seen on ultrasound in as many as 70 percent of adults. The vast majority of these are benign regions of thyroid tissue that pose no health risk. The minority of these are true tumors of the thyroid and may require further diagnosis or treatment. An ultrasound of the thyroid is typically used: to determine if a lump in the neck is arising from the thyroid or an adjacent structure to analyze the appearance of thyroid nodules and determine if they are the more common benign nodule or if the nodule has features that require a biopsy to look for additional nodules in patients with one or more nodules felt on physical exam to see if a thyroid nodule has substantially grown over time

Ultrasound – Scrotum

Ultrasound imaging of the scrotum provides pictures of the testicles and the surrounding tissues of a man or a boy. Ultrasound imaging of the scrotum is the primary imaging method used to evaluate disorders of the testicles, epididymis (a tube immediately next to a testis that collects sperm made by the testicle) and scrotum. This study is typically used to: determine whether a mass in the scrotum felt by the patient or doctor is cystic or solid and its location diagnose results of trauma to the scrotal area diagnose causes of testicular pain or swelling such as inflammation or torsion evaluate the cause of infertility such as varicocele look for the location of undescended testis Ultrasound can often detect an absent or undescended testicle as well. The testicle normally migrates from the abdomen, down the inguinal canal and then into the usual position in the scrotal sac. If it is not present in the scrotal sac, it may have stopped on its way and lie in the inguinal region, in which case the ultrasound examination will often see it. If it has not left the abdominal cavity, it may not be seen by sonography. If a testicle is not detected, a urologist may be consulted in order to decide whether additional imaging such as an MRI is needed to determine its location. If the testicle is found to be in the inguinal region, it can be moved into the scrotum. If left in the abdomen too long, it may become cancerous and may need to be removed. Ultrasound can identify testicular torsion, the twisting of the spermatic cord that contains the vessels that supply blood to the scrotum. Caused by abnormally loose attachments of tissues that are formed during the fetal development, torsion commonly appears during adolescence, and less often in the neonatal period, and is very painful. Torsion requires immediate surgery to avoid permanent damage to the testes. Ultrasound also can be used to locate and evaluate masses (lumps or tumors) in the testicle or scrotum. Collections of fluid and abnormalities of the blood vessels may appear as masses and can be assessed by ultrasound. Masses, both outside and within the testicles may be benign or malignant and should be evaluated as soon as they are detected.

Ultrasound – Hip

Ultrasound images of the hip provide pictures of muscles, tendons, ligaments, joints, bone and soft tissues of the hip. In infants, the hip (which has a ball and cup configuration) is composed mainly of cartilage and is easily recognized on ultrasound. Hip ultrasound images are typically used to help evaluate: abnormalities of the muscles, such as tears and soft-tissue masses. foreign bodies, bleeding, infections or other types of fluid collections. benign and malignant soft tissue tumors. early changes of arthritis.

Ultrasound – Cranial

A head ultrasound examination produces images of the brain and the cerebrospinal fluid that flows and is contained within its ventricles, the fluid filled cavities located in the deep portion of the brain. Since ultrasound waves do not pass through bone easily, this exam is most commonly performed on infants, whose skulls have not completely formed. The gaps between those skull bones provide a “window,” allowing the ultrasound beam to freely pass into and back from the brain. The ultrasound probe and some gel are placed on the outside of the head in one of those regions without bone. In adults, head ultrasound is used to locate and evaluate tumor masses during brain surgery, facilitating their safe removal.

Ultrasound – Carotid

An ultrasound of the body’s two carotid arteries, which are located on each side of the neck and carry blood from the heart to the brain, provides detailed pictures of these blood vessels and information about the blood flowing through them. A Doppler ultrasound study is usually an integral part of a carotid ultrasound examination. The carotid ultrasound is most frequently performed to detect narrowing, or stenosis, of the carotid artery, a condition that substantially increases the risk of stroke. The major goal of carotid ultrasound is to screen patients for blockage or narrowing of their carotid arteries, which if present may increase their risk of having a stroke. If a significant narrowing is detected, a comprehensive treatment may be initiated. It may also be performed if a patient has high blood pressure or a carotid bruit — an abnormal sound in the neck that is heard with the stethoscope. In some cases, it is also performed in preparation for coronary artery bypass surgery. Other risk factors calling for a carotid ultrasound are: diabetes elevated blood cholesterol a family history of stroke or heart disease A carotid ultrasound is also performed to: locate a hematoma, a collection of clotted blood that may slow and eventually stop blood flow. check the state of the carotid artery after surgery to restore normal blood flow. verify the position of a metal stent placed to maintain carotid blood flow.

Ultrasound – Abdomen

An abdominal ultrasound produces a picture of the organs and other structures in the upper abdomen. A Doppler ultrasound study may be part of an abdominal ultrasound examination. Abdominal ultrasound imaging is performed to evaluate the: kidneys liver gallbladder pancreas spleen abdominal aorta and other blood vessels of the abdomen Ultrasound is used to help diagnose a variety of conditions, such as: abdominal pain or distention. abnormal liver function. enlarged abdominal organ. stones in the gallbladder or kidney. an aneurysm in the aorta.

SPECT Scan

A single-photon emission computerized tomography (SPECT) scan lets your doctor analyze the function of some of your internal organs. A SPECT scan is a type of nuclear imaging test, which means it uses a radioactive substance and a special camera to create 3-D pictures. While imaging tests like X-rays can show what the structures inside your body look like, a SPECT scan produces images that show how your organs work. For instance, a SPECT scan can show how blood flows to your heart or what areas of your brain are more active or less active. The most common uses of SPECT are to help diagnose or monitor brain disorders, heart problems and bone disorders. SPECT can be helpful in determining which parts of the brain are being affected by: Dementia Clogged blood vessels Seizures Epilepsy Head injuries Because the radioactive tracer highlights areas of blood flow, SPECT can check for: Clogged coronary arteries. If the arteries that feed the heart muscle become narrowed or clogged, the portions of the heart muscle served by these arteries can become damaged or even die. Reduced pumping efficiency. SPECT can show how completely your heart chambers empty during contractions. Areas of bone healing or cancer progression usually light up on SPECT scans, so this type of test is being used more frequently to help diagnose hidden bone fractures. SPECT scans can also diagnose and track the progression of cancer that has spread to the bones.

Renal Scan

The kidneys filter the blood to remove waste substances such as urea (a nitrogen compound) and salt. The body discharges these wastes mixed in water as urine. The fluid is collected in the kidneys and discharged through the ureters which join the kidneys to the bladder. The top of the ureter is called the renal pelvis and this joins the kidney to the ureters. In a renal scan, images are made of the delivery of fluid into the kidneys via the bloodstream, concentration of wastes in the kidney and excretion or flow from the kidneys through the ureters and filling of the bladder. This test provides information on the blood supply, function and excretion of urine from the kidneys.

Parathyroid Imaging

A parathyroid scan is an exam to determine the function and health of the parathyroid gland which regulates calcium uptake in the body. This type of scan is called a sestamibi scan, after the tiny protein molecule that attaches to active parathyroid tissue in this test and that is injected into the blood stream as the first step in the test. Bound to a safe, low-level radioactive substance, this protein accumulates in abnormal parathyroid tissue and is then easily imaged by a detector that creates a nuclear-medicine image of any activity present in the parathyroids. (Note that normal parathyroid glands become dormant when blood calcium is high; thus, in the presence of an abnormal parathyroid gland, normal parathyroid glands are inactive and will not absorb the radioactive material and, therefore, do not become radioactive and, as a result, remain invisible on the scan.) An overactive parathyroid will show up as bright, radioactive spot. By knowing which of the four parathyroid glands is hyperfunctioning, a surgeon is able to remove only the one parathyroid gland that is producing excessive amounts of parathyroid hormone and no longer under the biochemical control of the body, and leave the other 3 normal parathyroid glands in place.

Indium WBC Tagging

An Indium-111 White Blood Cell (WBC) Scan is ordered when an infection is clinically suspected. An Indium-111 WBC Scan involves the injection of radioactive white blood cells into the vein through a small needle, followed by a Gamma camera scan to confirm or exclude a clinically suspected infection. Often, other tests including a bone scan and a sulfur-colloid bone marrow scan may be ordered for comparison with the Indium-111 WBC Scan. CT, MRI and/or ultrasound examinations may be suggested based on the results of the Indium-ill White Blood Cell Scan.

I-123 Thyroid Scan

The thyroid scan is used to determine the size, shape and position of the thyroid gland. The thyroid uptake is performed to evaluate the function of the gland. A whole-body thyroid scan is typically performed on people who have or had thyroid cancer. A physician may perform these imaging tests to: determine if the gland is working properly help diagnose problems with the thyroid gland, such as an overactive thyroid gland, a condition called hyperthyroidism, cancer or other growths assess the nature of a nodule discovered in the gland detect areas of abnormality, such as lumps (nodules) or inflammation determine whether thyroid cancer has spread beyond the thyroid gland evaluate changes in the gland following medication use, surgery, radiotherapy or chemotherapy

DaTscan

Each year, between 50,000 and 60,000 new cases of Parkinson’s disease are diagnosed in the United States. It is estimated that as many as one million people around the country suffer from the condition. A timely and correct diagnosis can help patients and their families overcome the fears and frustrations associated with getting an accurate diagnosis so they can move on with their lives. DaTscan™ is a radiopharmaceutical imaging agent that works by binding to dopamine transporters (DaT) in the brain. A specific marker for DaT, DaTscan™ produces images that provide visual evidence of the presence of dopamine transporters. DaTscan™ has been available in Europe since 2000 and has been used in nearly 300,000 patients in 32 countries. In 2011, the US Food and Drug Administration (FDA) approved DaTscan™ (Ioflupane I 123 Injection) for use as an imaging agent with single photon emission computed tomography (SPECT) imaging. This agent aids detection of dopamine transporters (DaT) in the brains of adult patients with suspected Parkinsonian syndromes (PS). Dopamine is a brain chemical that is classified as a neurotransmitter and is found in regions of the brain that regulate activities such as movement and emotion. DaTscan™ is the first FDA-approved diagnostic imaging agent to help physicians evaluate neurodegenerative movement disorders, such as idiopathic (of unknown cause) Parkinson’s disease (PD). This agent may be used in conjunction with other diagnostic evaluations to help differentiate essential tremor (an involuntary shaking of the hands, head, and voice) from tremor due to PS. DaTscan™ cannot differentiate between the different types of PS. DaTQUANT™ is an analytical tool that enhances the radiologist’s reading of each DaTscan study. This tool offers doctors a visual evaluation of the images acquired during the imaging exam, with this evaluation further assisting the detection of Parkinson’s disease. The benefit DaTQUANT™ provides to doctors is that the results are automatically generated through the analysis, can be reproduced repeatedly for validation, and are very accurate. A bone scan helps your doctor evaluate how your bones are working, and provides information to help diagnose and treat your condition. It can show injury to the bones, the effects of disease such as cancer or infection, as well as any improvement or deterioration in a bone abnormality after any treatment you might be having. With this type of statistical validation, this provides increased diagnostic confidence for the physician that their patient either has Parkinson’s disease or does not. “Ioflupane [DaTscan] may be an important new imaging agent for physicians in differentiating diseases such as Parkinson’s disease from Essential Tremor,” said Mark Stacy, MD, neurologist and director of the Duke Movement Disorders Clinic at Duke University Medical Center in Durham, NC. “Understanding exactly what you are dealing with is important in selecting the appropriate treatments for patients with movement disorders.” The FDA’s action, following a Priority Review, marks the approval of the first radiopharmaceutical agent to detect DaT distribution within the brain. Visualization of DaT distribution within the brain may help decrease diagnostic uncertainty in adult patients with suspected PS. The FDA granted DaTscan™ Priority Review due to an unmet clinical need for an imaging agent to assist physicians in managing patients according to their dopaminergic status. Parkinsonian syndromes are a group of neurodegenerative disorders (including multiple system atrophy, progressive supranuclear palsy and idiopathic Parkinson’s disease) characterized by rigidity, tremor and an impaired ability to walk. “Currently, movement disorders are diagnosed through clinical examinations, blood tests and neuropsychological evaluations, which are not conclusive and may lead to misdiagnosis,” Dr. Stacy said. “A new diagnostic adjunct to existing clinical assessments represents a meaningful contribution to the movement disorders field.” The FDA’s approval of DaTscan™ was based on two Phase 3 clinical trials confirming the efficacy of DaTscan for the visualization of DaT distribution within the striata, an interior part of the brain. These studies, evaluating 284 adult patients with tremor, demonstrated the consistent performance of DaTscan in the visual detection of DaT distribution in the brain when compared with a reference clinical diagnosis. “We are confident that DaTscan™, an objective and accurate marker of dopamine transporters, will better inform physicians’ diagnostic decisions,” said Stephen Lightfoot, MI-SPECT Segment Leader, GE Healthcare Medical Diagnostics. “By potentially enabling better disease management, we expect that DaTscan will greatly benefit the patient community.”

CereScan

CereScan is one of the country’s leading providers of SPECT (Single Photon Emission Computed Tomography) brain imaging for patients and physicians. Unlike an MRI (Magnetic Resonance Imaging) or a CT (Computed Tomography) scan, which provides information about structural (anatomical) abnormalities in the brain, a SPECT scan provides information about how your brain is working. This is a very important distinction. In many cases the brain’s structure may be normal, while the functioning is abnormal. How is a treating physician supposed to accurately know what is not working properly in your brain without looking? This comprehensive brain study takes approximately two and one-half hours to complete for each scan. An intravenous (IV) line is placed and radiopharmaceutical is injected, both critical components toward creating a “snapshot” of the brain. A quiet specialized camera rotates around the person to acquire the images.

DEXA Bone Density Study

What is a Bone Density study, or DEXA? Dual Energy X-ray Absorptiometry (DEXA) scan, also known as a bone density test, is painless and simple to conduct and usually takes less than 10 minutes. The radiation exposure is minimal and the test is very precise. During a DEXA scan, a scanner will pass over one area of your skeleton. A dual energy beam of very low dose x-rays passes through that area of your body and is measured by a detector. You will not feel anything during the exam. A certified radiology technologist at DIS will conduct the exam. You will be asked to lie still on the scan table but you will be able to breathe normally throughout the procedure. A scanner (using a dual energy beam of very low dose x-rays) will pass over the lower spine/hip area. You will not feel anything during the exam. DEXA technology works by measuring the amount of x-rays that are absorbed by the bones in your body. The two x-ray energies allow the machine to differentiate between bone and soft tissue, giving a very accurate estimation of bone density. The radiologist will produce a report for your physician based on the bone density measurements and your medical history. Despite advances in diagnostic techniques and therapies, many people at high risk of osteoporotic fractures are currently untreated. One of the most recent advanced in DEXA technology is the incorporation of a new tool developed by the World Health Organization called FRAX to help address this issue. FRAX allows the incorporation of a patient’s clinical risk factors to more easily identify those at greatest risk of fracture and in need of treatment. All DEXA exams completed by DIS automatically apply the FRAX tool. DIS is the first provider in the New Orleans area to offer single energy (SE) femur exams on a DEXA bone density study platform for the assessment of features associated with atypical femur fractures (AFF). This first-of-its-kind capability assists doctors and health care providers in their assessment of potential AFF in people who have been on anti-resorptive treatments such as bisphosphonates. This quick 15-second SE femur exam is designed to produce a high resolution image of the entire femur with a very low effective radiation dose. An AFF assessment can be conveniently performed at the time of a hip bone density scan with little or no body repositioning and a minimal increase in exam time. DIS offers SE femur exams at our west bank center in Marrero.

MRI Breast Biopsy

Magnetic resonance- or MR-guided breast biopsy uses a powerful magnetic field, radio waves and a computer to help locate a breast lump or abnormality and guide a needle to remove a tissue sample for examination under a microscope. It does not use ionizing radiation and leaves little to no scarring. Lumps or abnormalities in the breast are often detected by physical examination, mammography, or other imaging studies. However, it is not always possible to tell from these imaging tests whether a growth is benign or cancerous. A breast biopsy is performed to remove some cells from a suspicious area in the breast and examine them under a microscope to determine a diagnosis. This can be performed surgically or, more commonly, by a radiologist using a less invasive procedure that involves a hollow needle and image-guidance. Image-guided needle biopsy is not designed to remove the entire lesion.

Ultrasound

Ultrasound scanners consist of a console containing a computer and electronics, a video display screen and a transducer that is used to do the scanning. The transducer is a small hand-held device that resembles a microphone, attached to the scanner by a cord. The transducer sends out inaudible high frequency sound waves into the body and then listens for the returning echoes from the tissues in the body. The principles are similar to sonar used by boats and submarines. The ultrasound image is immediately visible on a video display screen that looks like a computer or television monitor. The image is created based on the amplitude (loudness), frequency (pitch) and time it takes for the ultrasound signal to return from the area of the patient being examined to the transducer (the device used to examine the patient), as well as the type of body structure and composition of body tissue through which the sound travels. A small amount of gel is put on the skin to allow the sound waves to travel back and forth from the transducer. Ultrasound is used to help physicians evaluate symptoms such as: pain swelling infection Ultrasound is also used to: guide procedures such as needle biopsies, in which needles are used to sample cells from an abnormal area for laboratory testing. image the breasts and guide biopsy of possible breast cancer. 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.

Breast Biopsy

Lumps or abnormalities in the breast are often detected by physical examination, mammography or other imaging studies. However, it is not always possible to tell from these imaging tests whether a growth is benign or cancerous. A breast biopsy is performed to remove some cells – either surgically or through a less invasive procedure involving a hollow needle – from a suspicious area in the breast and examine them under a microscope to determine a diagnosis. Image-guided needle biopsy is not designed to remove the entire lesion, but most of a very small lesion may be removed during the process. Image-guided biopsy is performed when the abnormal area in the breast is too small to be felt, making it difficult to locate the lesion by feel (called palpation). In ultrasound-guided breast biopsy, ultrasound imaging is used to help guide the radiologist’s instrument to the site of the abnormal growth. What are some common uses of the procedure? An ultrasound-guided breast biopsy can be performed when a breast ultrasound shows an abnormality such as: A suspicious solid mass A distortion in the structure of the breast tissue An area of abnormal tissue change There are times when your doctor may decide that ultrasound guidance for biopsy is appropriate even for a mass that can be felt. Ultrasound guidance is used in a biopsy procedure in which a biopsy needle is inserted through the skin to the site of an abnormal growth to collect and remove a sample of cells for analysis. This procedure uses an automated needle, which obtains one sample of tissue at a time. A small metal tube is inserted through the skin directed at the lesion to be biopsied, and left in place during the exam. The biopsy needle is placed through the metal tube eliminating multiple procedures. Procedure You will be positioned lying face up on the examination table or turned slightly to the side. A local anesthetic will be injected into the breast to numb it. Pressing the ultrasound transducer to the breast, the sonographer or radiologist will locate the lesion. A very small nick is made in the skin at the site where the biopsy needle is to be inserted. The radiologist, monitoring the lesion site with the ultrasound probe, will insert the needle and advance it directly into the mass. Tissue samples are then removed. After this sampling, the needle will be removed. Once the biopsy is complete, pressure will be applied to stop any bleeding and the opening in the skin is covered with a dressing. No sutures are needed. This procedure is usually completed within one hour. Ultrasound-guided breast biopsy is performed at the DIS Women’s & Advanced Imaging Center in Metairie.

Breast MRI

MRI of the breast offers valuable information about many breast conditions that cannot be obtained by other imaging modalities, such as mammography or ultrasound. MRI of the breast offers valuable information about many breast conditions that cannot be obtained by other imaging modalities, such as mammography or ultrasound. MRI uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. The images can then be examined on a computer monitor, transmitted electronically, printed or copied to a CD. Detailed MR images allow physicians to better evaluate various parts of the body and determine the presence of certain diseases that may not be assessed as well with other imaging methods such as x-ray, ultrasound or computed tomography (also called CT or CAT scanning). A registered technologist will position you on a padded scanning table which slides into our High Field Open MRI magnet where the imaging is performed. You will lie face down on your stomach with your breasts positioned into cushioned openings, which are surrounded by a breast coil. The breast coil is a signal receiver that works with the MRI unit to create the images. Click here for a two minute overview of breast MRI. An initial series of images will be taken. The patient is then given an intravenous injection of a special contrast material (called gadolinium) that helps to highlight various areas in the breast tissue. Several additional sets of images will follow. During the exam, you will need to lie very still and breathe normally. The technologist will offer you headphones to listen to music and help you relax. As the equipment scans, you will hear peculiar banging noises from the magnet which are completely normal. You may feel a slight vibration or warmth. It is important to remember that the DIS technologist can see and hear you at all times. A breast MRI study usually takes about 45 minutes. Some common uses for breast MRI include: Screening in women at high risk for breast cancer For women at high risk for breast cancer, typically because of a strong family history, MRI may be an appropriate tool to screen for breast cancer. A strong family history is defined as a mother or sister who has had breast cancer before age 50. It can also be aunts or cousins, including relatives who have had ovarian cancer. Your radiologist or primary care doctor can look at your family history and determine if screening MRI may be appropriate for you. Determining the extent of cancer after a new diagnosis of breast cancer. After being diagnosed with breast cancer, a breast MRI may be performed to determine: How large the cancer is and whether it involves the underlying pectoral muscle. If there are other cancers in the same breast and/or an unsuspected cancer in the opposite breast. If there are any abnormally large lymph nodes in the armpit, which can be a sign the cancer has spread to that site. Further evaluating hard-to-assess abnormalities seen on mammography. Sometimes, an abnormality seen on a mammogram cannot be completely evaluated by additional mammography and ultrasound alone. In these rare cases, MRI can be used to definitively determine if the abnormality needs biopsy or can be safely be left alone. Evaluating lumpectomy sites in the years following breast cancer treatment. Scarring and recurrent cancer look identical on mammography and ultrasound. If there is a change in a lumpectomy scar by either mammography or on a physical exam, MRI can help determine whether the change is normal maturation of the scar or a recurrence of the cancer. Following progress of tumor regression during neoadjuvant chemotherapy before definitive surgery to remove the breast cancer. In some cases, breast cancer will be treated with chemotherapy before it has been removed by surgery. In these cases, MRI is often used to monitor how well the chemotherapy is working and to re-evaluate the amount of tumor still present before the surgery is performed. Evaluating breast implants. MRI is the best test for determining whether silicone implants have ruptured. Breast MRI is performed at our DIS Metairie and Covington facilities.

Ultrasound – Pelvis

A pelvic ultrasound provides pictures of the structures and organs in the lower abdomen and pelvis. There are three types of pelvic ultrasound: A Doppler ultrasound exam may be part of a pelvic ultrasound examination. In women, a pelvic ultrasound is most often performed to evaluate the: uterus cervix ovaries fallopian tubes bladder Pelvic ultrasound exams are also used to monitor the health and development of an embryo or fetus during pregnancy. Ultrasound examinations can help diagnose symptoms experienced by women such as: pelvic pain abnormal bleeding other menstrual problems and help identify: palpable masses such as ovarian cysts and uterine fibroids ovarian or uterine cancers A transvaginal ultrasound is usually performed to view the endometrium, the lining of the uterus, and the ovaries. Transvaginal ultrasound also provides a good way to evaluate the muscular walls of the uterus, called the myometrium. Sonohysterography allows for a more in-depth investigation of the uterine cavity. Three-dimensional (3D) ultrasound permits evaluation of the uterus and ovaries in planes that cannot be imaged directly. These exams are typically performed to detect: uterine anomalies uterine scars endometrial polyps fibroids cancer, especially in patients with abnormal uterine bleeding Search Search What’s New at DIS The role of the radiologist in health care The difference between hospital based and outpatient imaging The difference between CT and MRI FDA approves the only mammogram superior for women with dense breasts Health insurance company begins shopper program Request an Appointment Online Registration

Ultrasound – Uterus

Sonohysterography, also known as saline infusion sonography, is a special, minimally invasive ultrasound technique. It provides pictures of the inside of a woman’s uterus. A Doppler ultrasound study may be part of a sonohysterography examination. It is a valuable technique for evaluating unexplained vaginal bleeding that may be the result of uterine abnormalities such as: polyps fibroids endometrial atrophy endometrial adhesions (or scarring) malignant lesions/masses congenital defects Sonohysterography is also used to investigate uterine abnormalities in women who experience infertility or multiple miscarriages.

Ultrasound – Breast

Ultrasound imaging of the breast produces a picture of the internal structures of the breast. During a breast ultrasound examination the sonographer or physician performing the test may use Doppler techniques to evaluate blood flow or lack of flow in any breast mass. In some cases this may provide additional information as to the cause of the mass. The primary use of breast ultrasound today is to help diagnose breast abnormalities detected by a physician during a physical exam (such as a lump or bloody or spontaneous clear nipple discharge) and to characterize potential abnormalities seen on mammography or breast magnetic resonance imaging (MRI). Ultrasound imaging can help to determine if an abnormality is solid (which may be a non-cancerous lump of tissue or a cancerous tumor) or fluid-filled (such as a benign cyst) or both cystic and solid. Ultrasound can also help show additional features of the abnormal area. Doppler ultrasound is used to assess blood supply in breast lesions.

Ultrasound – Obstetric

Obstetrical ultrasound provides pictures of an embryo or fetus within a woman’s uterus, as well as the mother’s uterus and ovaries. A Doppler ultrasound study may be part of an obstetrical ultrasound examination. During an obstetrical ultrasound the examiner may evaluate blood flow in the umbilical cord or may, in some cases, assess blood flow in the fetus or placenta. Obstetrical ultrasound is a useful clinical test to: establish the presence of a living embryo/fetus estimate the age of the pregnancy diagnose congenital abnormalities of the fetus evaluate the position of the fetus evaluate the position of the placenta determine if there are multiple pregnancies determine the amount of amniotic fluid around the baby check for opening or shortening of the cervix assess fetal growth assess fetal well-being

3D Mammography

Diagnostic Imaging Services offers the superior technology of 3D mammography within a relaxed non-hospital environment. 3D mammography is a revolutionary state of the art technology approved by the FDA in February 2011, which gives radiologists the ability to view inside the breast layer by layer, helping to see the fine details more clearly by minimizing overlapping tissue. During a 3D mammogram, multiple low-dose images known as “slices” of the breast are acquired at different angles. With 3D technology, the radiologist can view a mammogram in a way never before possible. The 3D exam is a separate procedure that is performed at the same time as your regular mammogram. The exam will take about 4 seconds longer per view while in compression. 3D mammography has been reported to provide results in superior clinical performance through the following three important areas: EARLIER DETECTION by minimizing the impact of overlapping breast tissue, 3D mammography can help improve breast cancer screening and detection. With 3D mammography, studies indicate radiologists are currently experiencing a 30 percent increase in breast cancer detection. FEWER CALLBACKS as 3D mammography helps distinguish harmless abnormalities from real cancers, leading to fewer callbacks and less anxiety for women. With 3D mammography, radiologists may be able to reduce patient callback rates by as much as 20-30 percent. BETTER VISUALIZATION as radiologists can better see the size, shape and location of an abnormality. 3D mammography is currently performed at the DIS East Bank center in Metairie, our West Bank center in Marrero, our Northshore East location in Slidell and our Northshore West Highway 21 location in Covington. When not covered by insurance, 3D is an optional service at this time and elected by the patient. Many physicians know about our new 3D technology and the feedback we have received has been very positive. If you need additional information to help you make this decision, please let the front desk know you’d like to speak to a technologist.

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