Radiology – Patient Information

The Hermitage Medical Clinic Radiology Department provides medical diagnostic imaging services which include a 64 Slice CT, MRI, PET/CT, SPECT CT, Nuclear Medicine, Mammogram, Ultrasound, X-ray and Fluoroscopy. This brochure is designed to give you a quick over view of all our services, what you can expect and some of the things that you need to do to prepare for your test.

At the Hermitage Medical Clinic we use a Digital Radiography (DR) system to acquire all of our x-ray images. This system allows the radiographer to see the images within 10 seconds of making the exposure. DR can save the patient from any additional exposure as a result of images being too dark or too light, as the computer can manipulate all images once acquired. Radiographs are an accurate and reliable way of obtaining helpful information in the diagnosis and treatment of many diseases, conditions and injuries. Minimal doses of radiation are used to achieve optimal results and x-ray examinations are well within permissible levels of diagnostic radiation. Women should always inform their doctor if there is any possibility that they are pregnant.

X-ray

What should I expect during an X-ray and how should I prepare?

You may be asked to change into a gown depending on the body part being x-rayed. X-ray imaging involves a small dose of radiation.

An MRI (Magnetic Resonance Imaging) scan uses a magnetic field and radio waves to take cross sectional images of the inside of the body. Unlike conventional radiography and Computed Tomographic (CT) imaging, MRI does not use ionizing radiation. An MRI system produces high-resolution, high-quality, detailed images of the human body. MRI aides in the visualization and detection of pathological changes within organs, blood vessels, bones and various other types of soft-tissue structures including injuries to muscles and ligaments.

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MRI

What should I expect during an MRI and how should I prepare?

During the scan, you will be required to lie on a bed while the area being scanned is placed in the centre of the magnet. This may cause some people to feel claustrophobic. Patients who are claustrophobic should talk to their GP before their appointment day. In some cases your GP may provide some medication to help you relax.

MRI is very loud so to help reduce the noise, ear plugs or ear defenders are used. You are able to listen to music during the MRI scan and therefore we encourage you to bring your favourite cds.

On average an MRI examination will last for 30 minutes. You will be required to hold very still, since motion can
result in images of poor quality.

It is important to wear loose, comfortable clothing, free of any metal. Please do not wear heavy makeup, jewellery or any other metal objects for the MRI scan as you are exposed to a powerful magnetic field. It is essential that you alert the radiographer if you have a pacemaker or artificial heart valve(s), surgical devices, any metal objects in your eyes or body. There is no need for fasting before most MRI scans. Women should always inform their doctor if there is any possibility that they are pregnant.

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CT

CT (Computed Tomography), previously known as a CAT scan, uses ionizing radiation to acquire cross sectional images or pictures of the inside of the body. The CT scanner emits and records x-ray beams for the duration of the scan.

CT scans can show several types of tissue with great clarity-lung, bone, soft tissue and blood vessels. Therefore, radiologists can easily diagnose problems such as different cancers, cardiovascular disease, infectious disease, trauma and musculoskeletal disorders. CT is also used in screening such as virtual colonoscopy and in radiotherapy treatment planning. In the Hermitage Medical Clinic, we have a current 64 slice scanner. Images can be acquired in sub second times minimizing motion artifact and scan times.

What should I expect during a CT and how should I prepare?

A CT scanner is a large machine with a hole in the centre. The patient will lie on a moveable examination table which moves up and down and slides in and out of the scanner. With modern CT scanners patients will hear only a slight clicking noise as the scanner revolves around you during the imaging process.

Metal objects can affect the image therefore you will be required to remove hairpins, jewellery, eyeglasses,
hearing aids and any removable dental work. You may be asked to drink water or a contrast material, a liquid
which allows better visualization of the stomach, small bowel and colon. Also many CT scans require an injection of iodine contrast. This will be injected through a cannula in your vein.

Women should always inform their doctor or radiographer if there is any possibility that they may be pregnant.

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Ultrasound

An Ultrasound examination obtains images of the internal structures of the body with the use of sound waves. These high frequency waves are transmitted through the skin, and reflected by the internal organs and structures to form a picture on a screen. Ultrasound is very useful in the diagnosis of many different pathologies.

Since ultrasound emits no x-rays, it is very safe. Ultrasound images can show the structure and movement of the body’s internal organs, as well as blood flowing through blood vessels. Ultrasound is often used in the detection of deep vein thrombosis and many vascular studies such as carotid scans. There are no known risks or side effects associated with diagnostic ultrasound.

What should I expect during an Ultrasound and how should I prepare?

During an ultrasound examination, a sonographer will apply gel to the area of interest. This helps the transmission of the sound waves through the skin. The sonographer will then move a handheld transducer over the skin surface. There may be varying degrees of discomfort from pressure as the transducer is pressed against the area being examined.

If you are having a pelvic examination, you may be asked to drink 1-1.5 litres of water about 45 minutes before the test. Patients should not empty their bladder until after the scan .This may cause some discomfort but it is necessary for pelvic ultrasounds. If you are having your gall bladder or pancreas investigated you may be instructed to stop eating for 6-8 hours before the test and to drink clear fluids only.

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PET / CT

PET/CT (Positron Emission Tomography/Computed Tomography) is a combination of two imaging tools which provides metabolic functional information from the PET scan with the anatomical information from the CT image.

It is used most frequently in oncology in diagnosing cancer cells, evaluating lesions treated by radiotherapy or chemotherapy and differentiating between inactive necrotic tissue or scar and lesions. PET scans can also be used to determine the blood flow to the heart and the brain.

A PET/CT exam not only helps your physician diagnose a problem, it also helps predict the likely outcome of various therapeutic alternatives, pinpoint the best approach to treatment, and monitor your progress.

What should I expect during a PET / CT and how should I prepare?

For the PET portion of the exam you will receive a radiopharmaceutical injection. The injection is a small amount of radioactive fluid which is used to identify areas in the body that are overactive (e.g. tumours) while the CT part of the scanner allows the radiologist to identify which organs are involved. This radioactive tracer must pass multiple quality control measures before it is used for any patient injection.

You must fast for six hours prior to your appointment time and you must avoid strenuous exercise the day before and the morning of the scan.

Women should always inform their doctor or radiographer if there is any possiblility that they are pregnant.

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SPECT / CT

Our SPECT/CT is a combination of two imaging tools which provides metabolic functional information from the SPECT scan with the anatomical information from the CT image.

During a SPECT exam, a radioactive material (radiopharmaceutical) is administered to a patient, usually by injection. This substance produces radiation, which is detected by a gamma camera. This differs from x-ray or CT examinations where the radiation comes out of a machine and passes through the patient’s body. Nuclear medicine images can assist the physician in diagnosing diseases. Tumours, infection and other disorders can be detected by evaluating organ function. Specifically, nuclear medicine can be used to analyze kidney function, scan lungs for respiratory and bloodflow problems, evaluate bones for fracture, infection, arthritis or tumour and determine the presence or spread of cancer.

What should I expect during the procedure and how should I prepare?

Radiopharmaceuticals (imaging agents) are given either by intravenous injection or inhalation. The imaging agent travels to specific organs and tissues dependent on the type of agent. Different agents go to different organs. The preparation for a nuclear medicine examination is usually limited to drinking plenty of fluids. However, if the procedure involves evaluation of the stomach, you may have to skip a meal before the test.

Women should always inform their doctor or radiographer if there is any possibility that they are pregnant.

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Fluouroscopy

Fluoroscopy is an imaging procedure that uses x-rays and a contrast agent to examine a specific part of the body. The contrast shows up white in the x-ray and is used to determine if there is an abnormality. The most common contrast media is barium, and this can be administered orally or rectally depending on the area under investigation.

The most common fluoroscopy studies are:

  • Barium Swallows and Barium Meals which examine the oesophagus, stomach and the first part of the small intestine (bowel).
  • Small Bowel Series which examines the small intestine (bowel)
  • Barium Enemas which examines the large intestine (bowel) or colon.

Fluoroscopy is used to screen for numerous pathologies, some of which include; ulcers, benign tumours (polyps, for example), cancer, diverticulitis and inflammatory diseases of the intestinal wall.

How should I prepare for a Fluoroscopic examination?

Many fluoroscopy procedures require the bowels to be completely clean so the area to be examined can be seen clearly. To get an unobstructed view of your gastrointestinal system, we require that patients have nothing to eat or drink after midnight and may not take any of their medication until after their examination. If necessary, a ‘preparation kit’ will be sent out a few days before the appointment with directions on how to prepare for the exam.

Women should always inform their doctor if there is any possibility that they are pregnant.

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Mammography

Mammography is a specific type of imaging that uses a low-dose x-ray system to examine breasts. The softer radiation produced helps to enhance the contrast between different types of breast soft tissue and make abnormalities more readily visible. A mammography exam, called a mammogram, is used to aid in the diagnosis of breast diseases in women.

What should I expect during the procedure and how should I prepare?

During mammography, a specially qualified radiographer will position your breast in the mammography unit. Your breast will be placed on a film cassette tray and a compression plate will be applied. You must remain very still and may be asked to hold your breath for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image. You will feel some pressure on the breast during compression but the compression will only last a few seconds and will be applied very gradually by the radiographer. The compression is needed to ensure that all areas of the breast tissue are seen and no small abnormality is missed, to lower the dose of radiation and to obtain a clearer image of the breast. There may be some slight skin discoloration or breast aching for a short time after the mammogram but compression will not cause any damage or long-term discomfort to the breast.

We recommend that you 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.

Women should always inform the radiographer if there is any possibility that they are pregnant

Precautions

In a number of cases, a woman may be asked to return on another date for an extra picture of the breast or an ultrasound of the breast after the Radiology Consultant has looked at the mammogram images. This is simply to get a clearer image of an area which the routine pictures have not shown in sufficient detail and should not be any cause for alarm – in the vast majority of cases this is simply to clarify a probably normal appearance and is precautionary.

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