When it comes to medical diagnosis and treatment, physicians and other practitioners use a vast range of procedures, methods, and tools in their care. Radiology plays a major role in the medical arena, and its importance only continues to grow as technology and science contribute continuous new advancements to the field. Radiologists work with a variety of scans, but the most commonly used are CT scan, MRI, general x-ray, and ultrasound. Depending on the nature of the injury or illness, a radiologist may use a single type of scan or use several scans in combination. How does the radiologist determine which scan to use in patient diagnosis and treatment?
A Closer Look at Common Radiology Scans
The x-ray is the most broadly used type of scan, and most people have probably had at least one x-ray in their life; dentists use x-rays to assist them in the proper treatment of patients’ teeth, for example. The x-ray scan uses electromagnetic energy waves to create images of the bones and other interior structures.
A CT (computerised tomography) scan is a more advanced x-ray which rotates to provide cross-sections of internal images. Using a higher dose of radiation, the CT is able to produce a much more detailed scan, which becomes important when diagnosing or treating certain types of issues.
Ultrasound is well-known for its use in monitoring pregnancy and providing images of the growing foetus inside the mother. Ultrasound technology does not use ionising radiation like the x-ray or CT scan, but uses sound waves to build images of the patient’s body.
Like the ultrasound, MRI, or Magnetic resonance imaging, does not utilise ionising radiation in its scans. Rather, MRIs work with magnets and radio waves to capture their internal images. An MRI is a scan which takes longer to complete, but the pictures it can produce are highly detailed.
Practical Applications of Radiology Scans
X-rays are very common, particularly for more “visible” ailments such as injuries. For broken bones or an overview of an internal organs, x-rays might be the best choice. Fast and effective, an x-ray produces an adequate scan with a reasonable dose of radiation. X-rays are generally considered the right scan for imaging bones, which explains their extensive use in dentistry.
A mammogram is specialised type of x-ray, used to scan women’s breasts for early indications of breast cancer. It is typically recommended for older women or those with a family history of breast cancer to be scanned yearly. In terms of early diagnosis, mammography is highly effective. Using x-ray technology, it does expose the patient to radiation, so its use should be as limited as possible and used minimally in young women.
When common x-ray is not appropriate, the more advanced CT scan might be chosen. The majority of CT scans use a significantly higher dose of radiation than the x-ray, but CT produces an image with much greater detail, as it creates 3D cross-section pictures of the patient. To minimise radiation exposure, CT scans can be highly localised onto the area of the patient’s body under analysis. A radiologist might choose to use a CT scan in cases of testing for abnormalities such as tumours or blood clots. Physicians often elect to use CT scans during surgeries or other tests to assist with navigating during the procedure, for example with the delicate workings of endoscopic sinus surgery.
Ultrasound is the scan of choice for observing growing babies within the mother’s womb. Ultrasound technology has grown by leaps and bounds, and extremely detailed images can now be procured. This technology is useful to radiologists as it does not subject the patient to any form of potentially harmful radiation, which is particularly important for the expectant mother. Additionally, ultrasound can be used for other purposes, such as soft tissue scans of the pelvis, extremities, neck, and abdomen or for musculoskeletal ultrasound: scanning for abnormalities in joints, muscles, and tendons. The radiologist might choose such a scan if other scans would unnecessarily expose a vulnerable patient to radiation.
Unfortunately, ultrasound is sometimes not effective enough to complete a full diagnosis. When scanning for cancerous lumps, for instance, ultrasound may be performed first followed by the more detailed MRI or CT scan. In their work, careful radiologists try to opt for the scan which presents the least possible risk for patients, but in some cases, additional, more advanced technology is required to form an accurate diagnosis. As always, the advantages and the risks will be weighed and the most beneficial course of action chosen.
MRIs and CT scans are both tools which offer a high level of detail. In many cases, a radiologist will decide which to use between these two scans. While both are very effective, the area of the body under evaluation will often guide the radiologist in his or her decision. MRIs are a good choice for scans of the ligaments, tendons, or spinal cord, as MRI tends to produce images with better density. Conversely, a CT scan might be selected in the case of internal organ injury or when testing for blood clots, tumours, or other masses.
Choosing the Right Scan for the Job
Which scan to use depends upon many factors. The radiologist typically works closely with the patient’s physician, and together they determine which scan(s) will be most effective for their patient’s needs. In addition to selecting the scan which will provide the highest level of detail, radiologists must also consider what scans tend to produce the best images and results for the specific ailment in question. Other considerations include the patient’s age, level of health, and previous exposure to radiation. The radiologist will select the best tool for the job as well as the scan that will be safest for their patient. It’s important for the physician and radiologist to strike the proper balance between efficacy and protection. At Vision XRAY, our radiologists strive to minimise radiation whenever possible, and the health and safety of our patients is always our priority.
You may have heard that Vision XRAY offers teleradiology services within our practice. Yet you may be left wondering: just what is teleradiology? Teleradiology is the sharing of radiological medical images such as x-rays, MRIs and CT scans via electronic technology. The purpose of this system is to allow patient information to be available remotely. This helps to achieve greater accuracy, efficiency, and speed when it comes to patient diagnosis and treatment. The ability to share imaging easily and quickly allows patients and radiologists access to other radiologists as well as specialists. It also facilitates simple communication between physician and radiologist. Working with our healthcare partners, we enable rapid image sharing with community medical centres, hospitals, and private health centres.
Teleradiology at Vision XRAY
At Vision XRAY we use the RRRA (Remote Radiology Reporting Australia) system of teleradiology. RRRA was the first teleradiology practice in Australia, founded in 2001 and expanding ever since. We have 8 certified teleradiologists at Vision, and they prepare and handle imagery from MRI, CT scans, ultrasound, cone beam CT, dental x-ray, and chiropractic x-ray, among others. In most cases, images are transmitted within a timeframe of 24 hours–faster during emergency or urgent circumstances.
Technologically speaking, the RRRA teleradiology system is very advanced. Information is shared via a secure PACS system using Wide Area Network (WAN) and broadband as well as wireless options. A VPN as well as other protective measures ensures security and confidentiality of transmitted data. The IT infrastructure is strong and expertly-managed; in the case of any outages or errors, the system is supported by multiple servers, data backups, and other fail-safe mechanisms to keep the program up and running. At Vision XRAY, our teleradiologists have dedicated workstations for sending and receiving imagery, equipped with state of the art technology.
Practical Applications and Benefits
Thirty or so years ago, technology necessitated that radiologists physically be present when their expertise was needed. Teleradiology has vastly altered the process for analysis and diagnostic of medical imaging; radiology remains at the forefront of ‘telemedicine’ or medical care provided remotely or across several locations. The use of teleradiology allows radiologists to communicate clearly and easily with hospitals, physicians, surgeons, and more. This has certainly changed radiology practices, allowing radiologists to work effectively in various locations and streamlining and improving the process for patients.
As a patient at Vision XRAY, we may use teleradiology as an effective tool in your diagnosis and treatment. Communication with doctors, hospitals, and radiologists is better facilitated through the use of this premier technology and you can feel confident that Vision XRAY is committed to continuing to use the best available technology and practices available.
Many physicians and radiologists the world over agree that self breast exams can be instrumental in assisting with early breast cancer detection. Once a month is the recommended frequency, and a self breast exam can be done easily, at home, and takes only about 5 minutes of your time. For women with a family history of breast cancer, self exams are vital, as are regular mammogram and ultrasound scans after a certain age. But for all women, becoming familiar with your own body and self-monitoring for any changes can help you detect any problems as soon as they become apparent.
How To Perform a Self Breast Exam
A self breast exam only requires a few minutes of your time. Many physicians recommend performing the exam while you’re in the shower, but there are a few different methods and positions you can use to examine yourself. The National Breast Cancer Foundation in the US provides a comprehensive explanation of self breast exams. To check your breasts, first do a visual inspection. It is important to look for any visible changes in the breast shape or tissue, particularly any dimpling or changes affecting only one breast or one side. Following this, you can perform a manual exam. Pressing your fingers gently but firmly, move them in a circular pattern starting from the outside of the breast and working your way inward. As you feel, take note of anything which feels unusual, hard, or lumpy. Make sure to examine your armpits for any signs of lumps or changes as well.
What if I Find a Lump?
If you detect a lump or notice any other changes or abnormalities in your breasts, you should consult with a physician. The majority of lumps prove noncancerous, and getting more comprehensive exams can help set your mind at ease or, in the event that you do require some treatment, get you started as soon as possible.
If your physician recommends diagnostic scans to examine a lump, you will probably begin with a basic breast ultrasound. Painless and completely noninvasive, ultrasound can be effective in determining the density of any mass found in the breast tissue. There is no radiation associated with this scan. The ultrasound can indicate whether further tests are needed.
Breast MRI and mammography are other diagnostic options which may be employed if your physician and radiologist find it necessary. At Vision XRAY, we always strive to perform only those scans and tests which are most necessary and best recommended for each particular case.
A Focus on Regular Exams
Self breast exams, while important, are not a foolproof or fully effective method of diagnosis. The recommendation to perform them regularly emphasises the importance of becoming familiar with one’s own breast tissue, resulting in better, faster recognition when something may be wrong, or when changes appear. This can lead to more rapid diagnosis and treatment in some cases. However, self breast exam is no substitute for the inspection and guidance of a qualified physician. In addition to examining your breasts frequently, leading research recommends your breasts be examined by a doctor every 1-3 years (once per year after the age of 40). With regular, comprehensive checkups, you can feel secure about the health of your breasts.
For more information about self breast exams, breast ultrasound, mammography, and MRI, or to learn more about our dedicated Australian Breast Centres, please contact us at Vision XRAY today. We will be happy to speak with you and address any concerns regarding breast health.
Unfortunately, many patients will experience joint pain throughout their life. This can occur particularly as the body ages, sometimes caused by arthritis, but joint pain can also transpire as a result of strain, overuse, or injury. Radiology is one of the most effective diagnostic tools available for investigating joint pain. Through various mediums such as XRAY, Ultrasound, MRI, and CT scan, radiologists and physicians can closely examine the patient’s joints and surrounding structures, helping to determine the cause of the problem and find appropriate solutions.
Where Does Joint Pain Occur?
Joint pain may affect any joint within the body, but common areas of pain include the hips, shoulders, wrists, and knees. Joint pain may be caused by inflammation of tendons and ligaments, mal-alignment of joints, loss of cartilage, fractures, or related stresses and injuries.
Patients with arthritis or knee issues will commonly be referred for an XRAY. Your orthopaedic physician may request specific XRAY images of various angles of the joint in question. For knee pain, an XRAY can often indicate whether there is a fracture or bone spur. Your physician may closely examine the images to check for joint alignment and joint space. For arthritic patients, shrinking joint space can indicate a loss of cartilage and help determine the severity of the arthritis.
Ultrasound uses reflection of sound waves to produce an image and does not use ionising radiation, making it a harmless test. It is a dynamic examination so you can see movement both normal and abnormal. Ultrasound examines soft tissues so images can show ligaments and tendons. As it can also observe blood flow, this scan is also useful in assessing inflammation, as there is typically an increase in blood flow to the affected area.
For examining joints, a CT scan is another important tool for diagnosis. While XRAY is helpful for observing bone structure and problems with
cartilage and joint alignment, CT scan provides more detailed images of internal structures such as tendons and ligaments. The CT scan allows the physician to note problems with these structures as well as the internal structure of bones. In the shoulder, for example, there are several tendons which can be prone to tearing or inflammation. A rotator cuff tendon is a commonly injured area of the shoulder.
As the shoulder is a multi-layered area, an MRI is a frequently used scan for this part of the body. MRI scans can show the soft tissue as well as the bone, so this test can be especially useful in observing swelling. The MRI allows the radiologist and physician to see further detail of the interior structures. Frequently, an arthrogram is utilised to investigate shoulder pain. An arthrogram involves an injection of a contrast dye, which helps internal areas show up much more clearly on our scans. The arthrogram can be used in conjunction with a CT scan, ultrasound, or MRI.
There are many useful diagnostic tools and tests for determining the cause of joint pain throughout the body. Your radiologist, alongside your physician, will determine which scans are most appropriate for each patient. If you are experiencing any current joint pain, do not hesitate to contact your physician immediately. Injuries or other problems can be dealt with, and our radiology technology here at Vision XRAY is excellent for investigating these issues. Your doctor can refer you for a diagnostic scan, and together we’ll help determine the cause of your pain.
The third trimester is an exciting time, as the moment will soon be arriving for baby’s arrival! Typically in the third trimester, ultrasound scans are not as necessary or as common. There are a few reasons that a third trimester scan might be needed, which we can explore.
A third trimester scan might be required to check the baby’s growth. This is sometimes referred to as a Foetal Wellbeing Scan. This might be performed if earlier scans showed abnormalities in growth which need a followup. If you’ve had previous pregnancies with complications, a third trimester scan might be recommended to make sure everything is on track.
If you suffer from any health conditions, including pregnancy-related pre-eclampsia (high blood pressure), a third trimester scan is common. This late scan allows the technician and physician to ensure that everything looks good with the health of both mother and baby.
As time inches nearer to the birth of your baby, a third trimester scan will ascertain that everything is in place for a successful birth. This ultrasound can determine the location of the placenta. It’s important that the placenta is not covering the cervix. As well, the scan will look to see that the foetus is not in a breech position. The position of the baby is important for delivery. A third trimester ultrasound is also common when the expectant mother is carrying multiples, such as twins or triplets. It is necessary to check for proper, normal growth in the third trimester, as well as observe the position of the foetuses.
Pregnant women who are over the age of 35 might also be candidates for a third trimester ultrasound, as there are sometimes more risks with these pregnancies.
Yet another reason for a third trimester ultrasound is in the event that you pass your due date with no sign of baby. In this case, your physician will likely want to monitor foetal heart rate and amniotic fluid levels.
As with other pregnancy ultrasounds, the scan is completely safe for both mother and baby. The technology uses no dangerous radiation, but instead uses sound waves to produce images of the foetus and womb. An ultrasound scan is a quick, painless procedure during which you should feel completely relaxed. Our competent, caring technicians are happy to work with you and show you images of your new baby.
Around 18-20 weeks, an ultrasound will be performed which is commonly known as the foetal morphology scan. This ultrasound checks your baby to make sure he or she is developing normally. The sonographer will look for any abnormalities in growth. The baby’s size will be measured and heartbeat registered. The location of the placenta will also be determined and the amniotic fluid volume measured.
As with any ultrasound, this is a very safe technology. Ultrasound scans do not utilise any ionising radiation, so they are completely safe for both mother and baby.
During the foetal morphology ultrasound, the sonographer will look at all of your baby’s growing internal organs. The heart, stomach, and kidneys are observed to check for signs of normal development in shape, size, and function. The head will be looked at by the sonographer to make sure there are no problems. The circumference of the foetus’ head is also typically measured as part of the typical check for size and proper growth. An important part of your baby that will be checked during this ultrasound is the spine. Abnormalities such as spina bifida are very-well detected by this scan. Other problems that the sonographer will be scanning for include gastrointestinal defects, some congenital heart problems, hydrocephalus (excess fluid in the brain), and missing or shortened limbs. In the event an abnormality was identified, further scans and tests would be required. Some abnormalities are non-threatening for the baby or resolve themselves at further stages in the baby’s growth. You can speak with your physician or sonographer about any concerns you may have.
While taking inventory of the baby’s healthy development, the sonographer will also be confirming the due date of the baby, making sure there are no multiple births (as these would be readily apparent by this time), and possibly determining the sex of the baby. The gender can usually be ascertained during this scan, but it is completely up to you whether or not you want to find out then if you’ll be having a boy or girl!
Between the 11th and 14th week of pregnancy, your healthcare provider may suggest a nuchal translucency assessment, commonly known as an NT scan. This very common screening tool helps assess the health of your baby in determining possible chromosomal abnormalities and congenital defects. This test is frequently used to check if your baby is it risk of disorders such as Down Syndrome.
How is the Scan Performed?
The nuchal translucency scan is a very simple, noninvasive procedure which is performed using ultrasound. The NT scan is done between 11- 13wks 6days gestation. At this stage of the pregnancy there is an accumulation of fluid behind the fetal neck which we measure. This accumulation of fluid is called the Nuchal Translucency. There are 2 parts to this NT scan: 1st part is the measurement of the nuchal thickness, the fetal length and doing a limited scan to check the heart rate, check that all limbs are present, check for brain tissue in the skull and look at the fetal profile to see that the nasal bone is present.
The 2nd part of the test is for the mother to have a blood test at a reputable pathology laboratory to check the hormone level in the mother’s blood. The hormone level in the blood corresponds to the fetal length. The blood test needs to be done within 48 hours of the scan. The NT scan is often done during one of your routine ultrasounds between 11 and 14 weeks.
What Does the NT Scan Diagnose?
While the nuchal translucency assessment does provide evidence of the increased risk of chromosomal disorders, it cannot alone serve as a diagnostic tool. If the test indicates a possible risk, your healthcare provider will suggest further testing to determine whether or not your baby does indeed carry a chromosomal disorder. These further tests would include blood tests or more invasive testing such as an amniocentesis or a chorionic villus sampling . These tests are stronger indicators for making an official diagnosis.
Who Should Have the Nuchal Translucency Assessment?
Every expectant woman carries a risk that her fetus/baby has a chromosomal defect. The risk of a chromosomal abnormality increases with maternal age, or with women with a family history of chromosomal disorders ,or women who has had a previous chromosomally abnormal pregnancy.
Is the NT scan safe?
The NT scan is a perfectly safe and noninvasive procedure. Your technician doing the scan is accredited with the Fetal Medicine Foundation and will be happy to answer any questions you may have. Please do not hesitate to contact Vision XRAY with any concerns.
Carrying life is an amazing experience for a woman, and many are anxious to see more of their future child via ultrasound scans. As technology has developed and improved greatly over the years, ultrasounds can now provide more information than ever. While later ultrasounds are much increased in detail, even the earliest ultrasounds can present technicians, doctors, and expectant parents with particulars regarding their baby’s growth and health.
5 weeks is the earliest point at which a pregnancy ultrasound can be completed. This ultrasound is typically a transvaginal ultrasound, as an abdominal ultrasound will not reveal many signs of pregnancy development yet. At approximately 5 weeks, the gestational sac can be seen via transvaginal ultrasound. This is the structure in which the embryo will grow, and can generally be seen before the embryo itself is visible.
Around 6 or 7weeks, an abdominal ultrasound will show the gestational sac. A transvaginal ultrasound given at this time is likely to show images of an early developing embryo. At this point the ultrasound technician can see the location of the embryo in the uterus and if it is an the proper, healthy location. These scans can help determine if there are signs of an ectopic pregnancy. The transvaginal ultrasound at 6-7 weeks can also show signs of the fetal heartbeat! At this point you will likely know if you have a twin pregnancy.
It is around the 8th week of pregnancy that ultrasound photos will begin to have increased detail. The heartbeat is clearly accessible, as well as arm and leg buds on the growing fetus.
First Trimester Pregnancy Ultrasound (12 weeks)
Although the earlier scans are possible (and typically done by transvaginal ultrasound), the most typical first trimester ultrasound is recommended around 10-14 weeks of gestation. This is generally performed by abdominal ultrasound and should provide images of the baby which look more “familiar” to the expectant parents. This as an exciting event as the parents finally get a real “look” at their baby for the first time!
This ultrasound shows greater detail and allows the technician to assess the baby’s size and growth. At this time, a more accurate due date can be given. The technician will measure the size of the fetus from its head to its bottom, called the Crown Rump length. This measurement helps determine the speed of the baby’s growth and is important in determining due date. During this pregnancy ultrasound, movement of the baby can be clearly seen, as well as recognizably developed arms and legs. Although the ultrasound can detect movement of the baby, the mother will not yet be able to feel it inside her.
12 weeks is approximately the time when fairly accurate screening tests can be performed for Down Syndrome. This can be assessed using a test called nuchal translucency, which measures the amount of fluid in the base of the fetus’ neck. Those with a likelihood for Down Syndrome commonly have more fluid in this region. This is not always indicative of the presence of Down Syndrome, however, and further tests are needed to confirm.
Ultrasound procedures are a common diagnostic tool which uses penetrating sound wave technology to produce images of the interior of the human body. In detecting cancerous lumps, an ultrasound is generally a complementary diagnostic tool alongside an additional scanning method, such as MRI.
Ultrasound procedures can serve as excellent primary diagnostic tools. In the case of the kidneys, for example, an ultrasound examination can identify kidney stones, obstructions, and possible tumors. Ultrasound technology is best utilised for determining structural changes to an organ or region of the body. Ultrasounds detect internal masses and can provide information about the quality of these masses. For instance, in a breast ultrasound, the scan helps to pinpoint differences in masses in the breast, distinguishing whether a lump is a fluid-filled cyst (more often benign) or a solid mass (potentially cancerous). The ultrasound provides an initial picture of a mass, indicating whether or not further diagnostic procedures, such as a tissue biopsy, will be necessary.
Breast ultrasound is a common type of ultrasound procedure. Typically, a breast ultrasound is ordered as a result of a lump discovered in the breast during a routine examination or a mammogram. Ultrasound is the next step, as it is a noninvasive procedure which allows doctors a detailed image of the internal tissue structures. An ultrasound can be especially useful alongside a mammogram, as the ultrasound can assist the radiologist in interpreting the results of the mammogram. In a mammogram procedure, both cystic masses and solid masses (potentially malignant) have a similar appearance. Using ultrasound procedures, the radiologist can investigate this mass of dense tissue more closely and with varying detail, helping determine the quality of the mass.
Most clinical diagnoses require multiple diagnostic tools and procedures to help determine an illness or abnormality. While ultrasound itself cannot diagnose cancerous lumps, when used alongside other technologies, it is an invaluable tool in aiding a diagnosis.
There are several instances in which it may be necessary for a child to undergo an ultrasound. In these cases, a parent’s primary concern will be for the comfort and safety of their child. At Vision XRAY Group, we hope to assure you of the complete safety of ultrasounds for children.
Ultrasound technology utilises sound waves to help create images of the body. These sound waves cannot be felt or heard. Because ultrasound uses sound waves, and does not use any potentially harmful ionising radiation, the ultrasound for children is a completely risk-free procedure. An ultrasound is a quick and easy noninvasive examination, and is performed without the necessity of sedating the child, or even requiring them to hold perfectly still. At times, an older child may be asked to take a deep breath during the ultrasound. Another benefit of child ultrasound is the absence of any side effects. A fast and totally painless examination, the child can undergo their scan at one of our sites, and return immediately to school or to home.
Child ultrasound is commonly used for abdominal ultrasounds. This is useful in diagnosing appendicitis, scanning after injury or trauma, or helping determine the cause of abdominal pain or problems. We perform paediatric hip ultrasounds on children or infants, if the birth indicates potential problems, or if child has an abnormal clinical examination, or shows signs of pain or an inability to bear weight. Ultrasound for children is also useful for bladder scans, to help diagnose problems such as urinary tract infections or gall stones.
We help to put you and your child at ease during the ultrasound. The technician will perform the scan with your child mostly positioned laying on his or her back or side. The ultrasound is painless, and your child should experience no discomfort. Your child will want to wear loose-fitting clothing, so that the technician can easily access the proper body areas for the scan. The technician will place a warm gel on your child’s skin, just covering the area which is to be scanned. The ultrasound transducer, or probe, is a handheld device, and should not seem too noisy or frightening to your child. The entire process of the child ultrasound should usually take half an hour or less.
A Useful Tool
Ultrasound is an excellent tool for diagnosing medical issues in both children and adults, and is a wonderful resource. Its effectiveness in producing quality internal images makes it a great option for scanning, and child ultrasound is a safe, noninvasive procedure which will be instrumental in helping your physician with the diagnosis and treatment of your child. At Vision XRAY Group, we assure you of your child’s safety. The ultrasound for children is one of the best possible choices for imaging technology which is safe, straightforward, and highly effective.