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In recent years the importance of a comprehensive approach to women’s imaging and preventive care has been underscored as a key component to good health management. At Eastside Diagnostic Imaging, PLLC as part of our commitment to women’s wellness we offer the full range of studies vital to ongoing monitoring and early detection of disease, which remains the best method for achieving cure.   Mammography plays a critical role in the early detection of breast
cancer. The U.S. Department of Health, the American Cancer Society,
The American Medical Association and the American College of Radiology
recommend annual screening mammography for women beginning at age 40. As with all radiological procedures patients should inform the technologist if there is any chance of pregnancy or if you are nursing. There are two basic types of Mammography: 1) a screening mammogram in which 2 basic views of each breast are taken and 2) a diagnostic mammogram which utilizes additional views if there is a symptom, family history or finding on screening mammography. At Eastside Diagnostic Imaging, PLLC patients are informed immediately of their mammogram results and if any additional imaging studies such as additional views, spot compression, an ultrasound or MRI are recommended. Patients have the option of having those procedures performed immediately. In between recommended breast screening all women should perform monthly self breast examination (SBE) and have a clinical breast exam (CBE) performed by their Gynecologist or Primary care Physician annually. Unfortunately mammography is not a perfect study. Five to ten percent of all screening mammography result in a “finding” that may appear abnormal and additional studies are required (ultrasound, fine needle aspiration and biopsy). Normal breast tissue may have a different pattern in each woman and the slightest movement or trace of deodorant, powder, lotion can compromise the image. Prior breast surgery, the presence of implants (silicone or saline) can block the view of tissue and distort results. Important things to know when having a Mammogram:
 Ultrasound may be used to evaluate palpable findings from a mammogram or physical exam or as an added study to mammography in cases where breast tissue is remove historically dense. The ability to visualize a finding on sonography greatly facilitates performing a biopsy, if required. Breast ultrasound may also be helpful in evaluating breast symptoms in younger patients, where mammography may be inappropriate due to radiation exposure.  Ultrasound maybe used to guide biopsy suspicious masses within the breast detected via mammogram or ultrasound. Tissue specimens are acquired using a vacuum assisted device or a traditional core. Breast biopsy is performed as an outpatient procedure, often avoiding the need for hospital admission or surgery.  Breast MRI has become an important adjunct to mammography and breast ultrasound. While mammography detects many breast cancers, its sensitivity is limited. Breast MRI uses vascular signals to look for cancers that may be too subtle to identify on mammography or ultrasound. In cases where there is a strong family history of breast cancer, breast MRI is often used to assess for otherwise occult malignancy. Eastside Diagnostic Imaging offers MRI guidance for core biopsy of lesions only visualized on breast MRI. Very few outpatient facilities have this capability. While breast MRI is very sensitive, it can sometimes detect lesions that mammography and ultrasound cannot see. As such, the ability to perform breast MRI biopsies makes breast MRI much more clinically relevant and we are confident that virtually all lesions identified can be sampled. Eastside Diagnostic Imaging offers the latest breast MRI technology, including computer aided diagnostic (CAD) software and dedicated breast biopsy coils. Breast MRI may be an appropriate test in addition to mammography for patients with a strong family history of breast cancer (i.e., mother/ sister with breast cancer before age 50). Breast MRI may also be helpful in patients recently diagnosed with breast cancer who desire breast conservation therapy or in patients with prior history of breast cancer where there is concern for tumor recurrence versus scar. Non contrast breast MRI is also the best test to evaluate breast implant integrity. Following placement in the MRI scanner, images are acquired before and following the injection of gadolinium. After the patient is imaged, computer processing of the images performs ‘subtraction' of the pre-contrast images from the post-contrast images. The procedure takes approximately 20 minutes and is noninvasive, except for the requirement of an intravenous injection. The newer MRI design results in a larger, shorter opening to the magnet. This feature vastly improves patient comfort and mitigates concerns of patients with claustrophobia.  Ultrasound, often referred to as sonography, is a method that obtains images of internal body organs through the use of high frequency sound waves which are recorded and displayed on a monitor. Images are captured in real time and therefore show movement of internal tissue, body organs, blood flow. Ultrasound is non-invasive and involves no radiation. Minimal preparation is needed for certain studies. Ultrasound is commonly used for assessment of the uterus and ovaries and is therefore a mainstay of women’s imaging, used not only in pregnancy but to evaluate irregular menstruation, pelvic pain and postmenopausal bleeding, among other issues. Sonohysterography involves distension of the uterus with sterile saline in order to obtain high resolution ultrasound of the uterine lining to evaluate irregular vaginal bleeding. Polyps as well as certain types of uterine fibroids are well evaluated with this technique. Some patients may require antibiotic therapy before or following the examination, which should be discussed with the gynecologist. Carotid ultrasound may show plaques that narrow the carotid artery and limit the flow of blood to the brain.  A hysterosalpingogram is a diagnostic test used to evaluate the inside of the uterus and fallopian tubes. It is a minimally invasive procedure; an injection of a contrast material is administered through the cervix through a small catheter to help the radiologist view the internal uterine structures. The images will show the shape and structure of the uterus as well as the condition of the fallopian tubes and any internal scarring. A hysterosalpingogram is usually prescribed for women who are having trouble becoming pregnant, to investigate the causes of repeated miscarriages or to monitor the effect of tubal surgery. Hysterosalpingography should be performed one week after menstruation but before ovulation to make certain the patient is not pregnant. It is also important for the bowels to be clear therefore a laxative or enema may be recommended. Some patients may require antibiotic therapy before or following the examination, which should be discussed with the gynecologist.  (Dual–Energy X-ray Absorptiometry) is an x-ray procedure which is used to measure bone mineral density. A DEXA scan is a simple and non-invasive procedure. Measurements of the lower spine, hips and sometimes the wrist are taken. The procedure is painless and radiation exposure is minimal. DEXA scans are recommended if you:
There is little or no preparation for a DEXA Scan. Eat as you normally do, however do not take any calcium supplements 24 hours prior to the exam. Dress comfortably and try to avoid garments with metal (zippers, belts, or buttons). You may have to wait 10-14 days before undergoing a DEXA Scan if you have had another diagnostic study which required the use of a contrast agent such as a barium enema, an upper/lower GI series esophagram; or have been injected with a contrast material for a computed tomography (CT) scan or radioisotope scan for a bone or PET/CT scan. As with all radiological procedures patients should inform the technologist if there is any chance of pregnancy. How is a DEXA scan performed? You will be asked to lie on the examination table for a short time while the arm of the machine passes over your body taking measurements. It is important that you stay as still as possible during the procedure to ensure a clear, useful image. A radiologist interprets the results of the DEXA Scan and provides a report to your primary care physician or gynecologist. DEXA report results will be in the form of two scores a “T” score and a “Z” score: T score — indicates the amount of bone you have when compared with a young adult of the same gender with peak bone mass. A score above -1 is considered normal. A score between -1 and -2.5 is classified as osteopenia, the first stage of bone loss. A score below -2.5 is defined as osteoporosis. It is used to estimate your risk of developing a fracture. Z score — indicates the amount of bone you have when compared to other people in your age group and of the same size and gender. If it is unusually high or low, it may indicate a need for further medical tests. If you would like additional information on these procedures we recommend visiting the Bone Densitometry (DEXA Scan) section of RadiologyInfo.org. If you would like additional information on these procedures we recommend you visit RadiologyInfo.org and the American Cancer Society. |
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