Procedures

Cardiac Ultra Sound

• 2D Echocardiography - It uses ultrasound to take real time pictures of the heart. It can help diagnose structural and functional problems in the heart. It is not dangerous, and a standard echo TTE has no risks.
   

• Stress Echocardiography - A test that helps diagnose heart disease with the help of ultrasound images. Following exercise or other stress to the heart, the images reveal parts of the heart that may not be receiving enough blood or oxygen because of blocked arteries.
   

• Transesophageal Echocardiograms - During the transesophageal echocardiogram (TEE) test, an ultrasound transducer (which produces high frequency sound waves) provides pictures of the heart's valves and chambers and helps the physician evaluate the pumping action of the heart.

  The ultrasound transducer is positioned on an endoscope (a long, thin, flexible instrument about 1/2 inch in diameter). The endoscope is placed into your mouth and passed into your esophagus (the "food pipe" leading from your mouth into your stomach) to provide a close look at your heart's valves and chambers without interference from the ribs or lungs.

CT

• 2D/3D Reconstructions
   
• Biopsies - CT biopsy can done almost anywhere in the body, as long as there is a radiologist trained in the technique. CT scans of the relevant part of the body are done and a needle is used to obtain a biopsy. The precise location of the needle is guided by the CT scan. The organs which are common biopsied using Ct scan are the liver, lungs, kidneys, pelvis, pancreas, pleura, lymph nodes, bone.
   
• General CT Procedures
   
• CT Angiography - Imaging technique used to visualize the inside, or lumen, of blood vessels and organs of the body, with particular interest in the arteries, veins and the heart chambers. This is traditionally done by injecting a radio-opaque contrast agent into the blood vessel and imaging using X-ray based techniques such as fluoroscopy.

General Radiology

• Arthrograms
  
  
• General Radiology Procedures

General Ultra Sound

• Abdominal - An abdominal ultrasound image is a useful way of examining internal organs, including the liver, gallbladder, spleen, pancreas, kidneys, and bladder. Because US images are captured in real time, they can show movement of internal tissues and organs and enable physicians to see blood flow. This can help to diagnose a variety of conditions and to assess damage caused by illness. Ultrasound imaging is used extensively for evaluating the kidneys, liver, gallbladder, pancreas, spleen, and blood vessels of the abdomen.
   
• Breast - A breast ultrasound uses sound waves to make a picture of the tissues inside the breast. A breast ultrasound can show all areas of the breast, including the area closest to the chest wall, which is hard to study with a mammogram. Breast ultrasound does not use X-rays or other potentially harmful types of radiation. A breast ultrasound is used to see whether a breast lump is filled with fluid or if it is a solid lump. An ultrasound does not replace the need for a mammogram, but it is often used to check abnormal results from a mammogram.
   
• OB/GYN - Obstetric ultrasound refers to the specialized use of sound waves to visualize and thus determine the condition of a pregnant woman and her embryo or fetus.
   
• Vascular - Ultrasound of the carotid arterial system provides a fast, noninvasive means of identifying blockages of blood flow in the neck arteries to the brain that might produce a stroke or mini-stroke. Ultrasound of the abdominal aorta is primarily used to evaluate for an aneurysm which is an abnormal enlargement of the aorta usually from atherosclerotic disease.
   
• Pelvic - A pelvic ultrasound provides pictures of the structures and organs in the lower abdomen or pelvis.
   
• Transvaginal - Transvaginal ultrasound is a method to look at a woman's reproductive organs, including the uterus, ovaries, cervix, and vagina. Transvaginal means across or through the vagina.

Interventional Radiology

• Angiograms
   
• Ballooning / PTA - Percutaneous transluminal angioplasty (PTA) is a procedure in which a thin, flexible catheter is inserted through an artery and guided to a location where the vessel has narrowed from some form of vascular disease such as plaque. Once in the desired location, a small balloon at the end of the catheter is inflated, compressing the plaque against the vessel wall and restoring blood flow.
   
• Biopsies - A biopsy is a medical test involving the removal of tissues or cells for examination. The tissue is then usually examined under a microscope by a pathologist, but can also be analyzed chemically.
   
• Epidurals - a form of regional anesthesia involving injection of drugs through a catheter placed into the epidural space. The injection can cause both a loss of sensation (anesthesia) and a loss of pain (analgesia), by blocking the transmission of signals through nerves in or near the spinal cord.
   
• Kyphoplasty - Designed to stop the pain caused by the bone fracture, to stabilize the bone, and to restore some or all of the lost vertebral body height due to the compression fracture. The procedure can be performed under either local or general anesthesia, on multiple levels, out-patient or in-patient, and is viewed as minimally invasive. It is most commonly performed for spinal compression fractures caused by osteoporosis, a condition that weakens the bone, and is also sometimes performed for certain other conditions that may have led to a spinal fracture.
   
• PICC Line Placements
   
• Radio Frequency Ablation (Lung / Renal) - RFA procedure is performed under image guidance such as CT scan or ultrasound by a group of physicians, known as "Interventional radiologists". Once the diagnosis of tumor is confirmed, RFA probe (needle) is placed inside the tumor. The radiofrequency waves passing through the probe increase the temperature with in tumor tissue that results in destruction of the tumor. Generally RFA is used to treat patients with small tumors that started with in the organ (primary tumors) or that spread to the organ (metastasis). The suitability of a patient to receive RFA is decided by doctors based on multiple factors.
   
• Stents
   
• Vein Ablation - Varicose vein treatment, or endovenous ablation, is a minimally invasive treatment that uses radiofrequency or laser energy to cauterize (burn) and close abnormally enlarged veins in the legs, a condition called varicose veins.

Mammography

• DEXA Bone Density - Bone density scanning, also called dual-energy x-ray absorptiometry (DXA) or bone densitometry, is an enhanced form of x-ray technology that is used to measure bone loss. DXA is today's established standard for measuring bone mineral density (BMD).
  
• Diagnostic/Screening Mammograms
  
  
• Breast Stereotactic Breast Localizations / Biopsy - Is a radiological technique for localizing breast lesions for biopsy by either fine-needle aspiration or needle-core biopsy. The technique requires that the breast be compressed between a compression paddle and a plate, called the image receptor, which can detect the x-ray beam and produce either a film image (mammogram) or a digital computer-generated image of the breast. Stereotactic localization is followed by a biopsy procedure, typically either a fine-needle aspiration or needle-core biopsy. Needle biopsies of palpable breast lesions do not require stereotactic localization.

MRI

• Abdominal and Pelvic MRI - Abdominal Magnetic Resonance Imaging (MRI) is a noninvasive test that uses powerful magnets and radio waves to create pictures of the inside of the belly area. It does not use radiation (x-rays).
   
• Breast MRI - Breast MRI uses Magnetic Resonance Imaging (MRI) to look specifically at the breast. It is a non-invasive procedure that doctors can use to determine what the inside of the breast looks like without having to do surgery or flatten the breast (as in a mammogram). Each exam produces hundreds of images of the breast, cross-sectional in all three directions (side-to-side, top-to-bottom, front-to-back), which are then read by a Radiologist. No radioactivity is involved, and the technique is believed to have no health hazards in general.
   
• Head and Spine MRI - MRI is the most sensitive exam for brain tumors, strokes and certain chronic disorders of the nervous system such as multiple sclerosis. Current MRI systems can depict brain function, and in this way detect stroke at a very early stage. In addition, it is a useful means of documenting brain abnormalities in patients with dementia and it is commonly used for patients with disease of the pituitary gland. MRI can detect tiny areas of tissue abnormality in patients with disease of the eyes or inner ear.
   
• MR Angiography - Angiography is a minimally invasive medical test that helps physicians diagnose and treat medical conditions. Angiography uses one of three imaging technologies and, in some cases, a contrast material to produce pictures of major blood vessels throughout the body. It is typically used to examine blood vessels in key areas of the body, including the brain, kidney, pelvis, legs, lungs, heart, neck, and abdomen.
   
• Musculoskeletal MRI - MR imaging 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, printed or copied to CD. MRI does not use ionizing radiation (x-rays). Detailed MR images allow physicians to better evaluate parts of the body and certain diseases that may not be assessed adequately with other imaging methods such as x-ray, ultrasound or computed tomography (also called CT or CAT scanning).

Nuclear Medicine/PET CT

• Myocardial Perfusion Imaging -Used to detect areas of decreased or absent blood flow to the muscle of the heart. The exam can take up to 4-5 hours. Preparation includes nothing to eat or drink 3 hours prior to the stress test and no caffeine of any kind after midnight.
   
• Biliary Scan - Biliary scans are used to check for obstructions within the biliary system and to calculate the function of the gallbladder. An injection of Cholecystikinase is given once the liver, gallbladder, and bowel are visualized. This injection causes the gallbladder to contract. Imaging then continues for 25 minutes. Biliary scans take 1 1/2 to 2 hours. Patient preparation: Nothing to eat or drink for four hours prior to the exam.
   
• Bone Scan - Bone scans are used to detect abnormalities within the bones. These abnormalities can range from fractures to metastatic disease. The exam consists of a injection of a radioactive isotope, followed by a waiting period of 3-4 hours, in which the patient is free to leave. The exam can take up to 4-5 hours (including the waiting period after injection). There is no preparation for this exam.
   
• Brain Scan - This is used to localize seizure activity within the brain. This exam is usually done under sleep deprived conditions while the patient is admitted to the hospital. The imaging is completed after the patient was injected with the radioactive isotope during a seizure. Imaging takes approximately 30 to 40 minutes. Patient Preparation: Patient will be asked to stop taking anti-seizure medication once they arrive at the hospital.
   
• Breast Sentinel Node Localization - Breast sentinel node localization is a tool to assist surgeons in detection of the sentinel node of the lesion during surgery. The Nuclear Medicine portion of the procedure takes 30 minutes for the injection and after a delay of 90 to 150 minutes another 30 minutes for imaging. Patient Preparation: None.
   
• Gallium Scan - Gallium is used to detect inflammation within the body. It can also be used to detect certain types of tumor, such as non-hodgkins lymphoma. Gallium scans are usually images 24 to 72 hours and could be done for three consecutive days.
   
• Gastric Emptying Scan - A gastric emptying study is used to determine the rate in which your stomach digests food. If motility is decreased, Reglan (a medication) may be injected into the patient's blood stream and another image follows 30 minutes later to determine if Reglan is a medication that will help. Gastric emptying scans will take 2 1/2 to 4 hours. Patient preparation: Nothing to eat or drink for 6 hours prior to the exam.
   
• I-131 Wholebody Scan - This scan evaluates if there is thyroid cancer.
   
• Lung Scan - Lung scans can be ordered to detect blood clots in the lungs (pulmonary embolism). The lungs may also be imaged to quantify the air flow and blood flow to the lungs. The lung scan for pulmonary embolism can take up to 1 hour. The lung scan for quantification will take 2-2 1/2 hours. There is no patient prep for these exams.
   
• MUGA or RNA - This scan is used to calculate the ejection fraction of the left ventricle of your heart. The scan takes 1 hour. Patient Preparation: None.
   
• Octreoscan - Imaging agent that can help find primary and metastatic neuroendocrine tumors.
   
• Thyroid Uptake/Scan - This exam is used to determine if a person’s thyroid is overactive. A small capsule of radioactive iodide is given to the patient. 4 hours after administration of the capsule the person returns for a series of counts over their neck. This will determine how much of the capsule has been picked up by the thyroid. Imaging then follows. The patient may need to return the next day for an additional series of counts over their neck.
   
• PET/CT- PET (Positron Emission Tomography) and CT (Computed Tomography) scans are both standard imaging tools that physicians use to pinpoint body disease states. A PET scan demonstrates the biological function of the body before anatomical changes take place, while the CT scan provides information about the body's anatomy such as size, shape and location. By combining these two scanning technologies, a PET/CT scan enables physicians to more accurately diagnose and identify cancer, heart disease and brain disorders.
   
• Renal Scan - These scans are used to determine the function of the kidneys. They can also be use to aid in the diagnosis of renal artery stenosis and for cortical scarring, due to frequent urinary tract infections. The patient is requested to be well hydrated prior to coming in for the scans unless otherwise directed. The exam can last 1-4 hours depending on the type of renal imaging your physician has ordered.