The origin of cancer is often obscured by metastases – tumors that have already spread to other tissues. This is especially the case for neuroendocrine tumors (NETs), a malignancy of nerve cells scattered throughout various organ systems that are sensitive to the signaling of neurotransmitters and hormones. An investigational molecular imaging technique could be the key to finding the elusive primary tumor, say presenters at the 2015 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI).
Prostate cancer is the second most deadly cancer in men, after lung cancer. There are an estimated 233,000 new cases of prostate cancer a year in the U.S. and 29,480 deaths, according to the National Cancer Institute.
A growing body of evidence shows that MRI can help physicians detect a larger percentage of aggressive cancers than conventional biopsies. Current medical practices dictate use of the prostate-specific antigen (PSA) test, which is followed up with a biopsy if PSA levels are determined to be high. Nonetheless, traditional ultrasound guided biopsies cannot always accurately target suspicious nodules, forcing patients to resubmit themselves to an uncomfortable procedure to achieve conclusive results.
MRI in Prostate Cancer Detection and Treatment
According to one study, published in July 2014 in European Urology, MRI used to detect prostate cancer can help triage patients with suspicious findings for targeted biopsy:
- • Reduce the number of cores taken by 84 percent
- • Reduce the number of biopsies by 36 percent
- • Reduce detection of low-risk cancer by 87 percent,
- • Increase detection of intermediate, and high-risk cancer by 18 percent.
Sumathi Reddy, consumer health columnist for the Wall Street Journal, notes in one article: “Because conventional biopsies can’t always distinguish when a cancer is clinically insignificant, patients sometimes undergo unnecessary surgery, radiation or other therapy. Such overtreatment has been a concern in the medical community for some time.”
Controversy over MRI as New Screening Standard.
A common objection to MRI screening use is that there are not many radiologists skilled in interpreting prostate MRI exams. Reddy remarks, “While it is important to note that experience matters, radiologists experienced with MRI in prostate cancer detection can offer greater clarity regarding rising PSA levels, prostate cancer diagnoses and prostate cancer prognoses.”
“Improved imaging with MRI may allow one to confidently recommend surveillance to a greater number of patients and to discover aggressive disease in areas that are not usually biopsied,” said Center for Cancer Research at the National Cancer Institute Clinical Director William Dahut, M.D. “No technology is perfect, that’s for sure. However, it is clear that our tools and ability to use these tools continues to markedly improve.”
The Center for Diagnostic Imaging is confident in the continued growth of prostate MRI exams, as it offers patients more accurate information about their disease to inform treatment decisions. MRI may well be the next frontier for cancer detection, as well as the new alternative to the current standard of care.
What is a Bone Density Scan?
Bone density is the measurement that defines the mineral content of the bone. The bone density is an identification number that can be used to indicate the strength of the bone and can also help in the diagnosis of osteoporosis.
A bone density scan is an imaging test that uses a specialized X-rays such that it causes a minimal damage on the body of the patient. For bone density a specialized X- ray test is mainly brought into use as if we go by a traditional method then it may be case that we are able to detect it only in the condition when the patient loses more than 50 percent of their bones.
Do you need a bone density Scan?
The recent medical survey indicates that 1 in 4 men and 1 in 8 women who are over the age of fifty are at a higher risk of developing osteoporosis. To avoid such a condition it becomes necessary for the people to have a bone density scan at a regular interval. Other groups that should consider a bone density test:
– All postmenopausal women below age 65 who have risk factors for osteoporosis.
– All women aged 65 and older.
– Women with medical conditions associated with osteoporosis. Your health care provider can tell you if you have a medical condition associated with osteoporosis.
– Men age 70 or older.
– Men ages 50-69 with risk factors for osteoporosis or medical conditions associated with osteoporosis.
– When the patient is experiencing any of the following problems they are advised to go for a bone density test:
Do you have Osteoporosis?
Osteoporosis is a condition that arises mainly when the mineral content in one’s body is less than the required. But then this is a very preventable condition, patients only need to adopt a correct diet and try to have a right lifestyle to prevent this problem.
What’s your age?
Women over the age of sixty five and the men over the age of seventy are advised to go for a regular bone density test. Whether it is men or women, if they are having a habit of smoking then also they are advised to go for a bone density check.
What is your family medical history?
The patients who are having a family history of Osteoporosis are at a higher risk of developing Osteoporosis. This test helps in earlier detection of thinning bones so that the required treatment can be pursued. People with Osteoporosis are advised to hold a proper intake of vitamin D and calcium. The people who are having continuous back pain or are having a stooped posture are also advised to go for a bone density scan.
What you need to understand when you are going for Bone density scan?
There are a number of bone density scans that a diagnostic center may provide you with. Following mentioned are some of the common test that can be used for the measurement of the bone mineral density of an individual:
- Dual-energy X-ray absorptiometry (DXA or DEXA): DXA is a bone density medical test that utilizes two different energies X-ray beams. Both the beams do individual scanning for the soft tissue and the bones of the individual. This test is mainly used for fetching the bone mineral density count in forearm, spine hip and also for a full body scan.
- Qualitative ultrasound (QUS): as we know that ultrasound is and non invasive technique of getting picture of the affected body part. With the development in technology, an ultrasound termed as Qualitative ultrasound can be used to get the mineral density of the concerned heel within seconds and also provide the patient with an E-ray of the structure.
- Single photon absorptiometry (SPA): As the name makes it clear this type of technique uses a single X-ray. For this the concerned body part whether it be heel or forearm is either enclosed in a tissue like structure or is submerged in water to obtain a reliable result.
- Quantitative computed tomography (QCT): Quantitative computed tomography is a type of CT scan. This test can be expensive and doesn’t track the progression of the Osteoporosis as well as DXA or DEXA.
The patients are advice to go for a regular bone mineral density scan (BMD) as it can help is making Osteoporosis reversible.
Genetic testing can be both informative as well as an effective preventative method by locating specific pre-cursors to disease: genomic bio-markers. According to the U.S. National Library of Medicine, “Genetic testing has potential benefits whether the results are positive or negative for a gene mutation. Test results can provide a sense of relief from uncertainty and help people make informed decisions about managing their health care. For example, a negative result can eliminate the need for unnecessary checkups and screening tests in some cases. A positive result can direct a person toward available prevention, monitoring, and treatment options. Some test results can also help people make decisions about having children. Newborn screening can identify genetic disorders early in life so treatment can be started as early as possible.”
Three of the most well-known abnormal genes are BRCA1, BRCA2, and PALB2. Women and men who inherit a mutation, or abnormal change, in any of these genes have a much higher-than-average risk of developing breast cancer and ovarian or prostate cancer. Continue reading
New advances in elastography from “The Technology Partnership” could lead to improvements in surgical procedures and enhance a doctor’s ability to navigate around the body during operations.
Elastography is a medical imaging technique that maps the elastic properties of soft tissue to provide diagnostic information during surgery. The process determines the stiffness of tissue and can be adapted to measure the level of muscle contraction. Cancerous cells, for example, will often be profoundly stiffer than the surrounding tissue and diseased livers are stiffer than healthy ones.
Elastography’s strength lies in its ability to image tissues and organs that ultrasound cannot reach. It also has the advantage of being more uniform across operators and less dependent on operator skill than most methods of ultrasound elastography.
Other types of Elastography include:
Transient elastography, however, “gives a quantitative one-dimensional (i.e. a line) image of tissue stiffness. It functions by vibrating the skin with a motor to create a passing distortion in the tissue (ashear wave), and imaging the motion of that distortion as it passes deeper into the body using a 1D ultrasound beam. It then displays a quantitative line of tissue stiffness data (the Young’s modulus). This technique is used mainly by the FibroScan system, which is used for liver assessment, for example, to diagnose cirrhosis.”
In Acoustic Radiation Force Impulse Imaging (ARFI) uses ultrasound to create a 2-D map of tissue stiffness. It creates a push inside the tissue using the acoustic radiation force from a focused ultrasound beam. By pushing into the tissue masses, a map of varying tissue densities is created.
Whereas Supersonic Shear Imaging gives a quantitative, real-time two-dimensional map of tissue stiffness. It is often called ‘Shear Wave Elastography’, though it is not the only method to use shear waves. Like ARFI and SWEI, supersonic shear imaging uses acoustic radiation force to induce a ‘push’ inside the tissue of interest, and like SWEI, the tissue’s stiffness is computed from how fast the resulting shear wave travels through the tissue. By using many near-simultaneous pushes, and by using an advanced ultrafast imaging technique to track the wave, supersonic shear imaging can make a two-dimensional quantitative map of the tissue’s stiffness (the Young’s modulus), and create one every second.
It has demonstrated clinical benefit in breast, thyroid, liver, prostate and musculoskeletal imaging. Ultrasound Elasticity Imaging is used for breast examination with a number of high-resolution linear transducers. A large multi-center breast imaging study has demonstrated both reproducibility and significant improvement in the classification of breast lesions when shear wave elastography images are added to the interpretation of standard B-mode and Color mode ultrasound images.
A study published in the World Heart Federation’s journal, Global Heart has revealed the potential of portable ultrasound technology to detect plaque in peripheral arteries. This early detection allows doctors to employ preventative treatments that can stop heart attacks and stroke before symptoms appear. Continue reading
What is imaging?
Imaging is a range of tests used to create images of parts of the body. These can help:
- screen for possible health conditions before symptoms appear
- diagnose the likely cause of existing symptoms
- monitor health conditions that have been diagnosed, or the effects of treatment for them.
Imaging is also called radiology. Doctors who specialise in imaging are called radiologists.
There are many different types of imaging, such as X-rays, CT (computed tomography) scans, MRI (magnetic resonance imaging) and ultrasound. Each imaging type uses a different technology to create an image.
This increasing range of imaging types provides health professionals with many options for showing what is happening inside your body.
Radiology technicians or imaging technologists are health professionals who are trained to use specific imaging types, such as radiographers for X-rays or sonographers for ultrasound imaging.
Is imaging the best option for me?
Like any medical procedure or treatment, imaging should be chosen to suit your individual needs. This means it shouldn’t be used routinely when you see a health professional.
For example, the first and most important step when making an accurate diagnosis of an injury is for your health professional to take your medical history and perform a physical examination. Imaging tests can help with a diagnosis, but they don’t replace this step.
Each decision involves weighing up the benefits and risks of having an imaging test.
|Early detection of problem||Exposure to radiation|
|Accurate diagnosis||Incidental findings leading to possibly unnecessary testing or treatment|
|Ongoing monitoring||Emotional stress|
|Contribution to choice of effective treatment||Cost|
|Improved management of condition|
In the end, an imaging test should only be performed if it’s likely to help with diagnosis and improve the management of your health condition or injury.
What are my imaging choices?
Common types of imaging include:
- CT (computed tomography) scan
- MRI (magnetic resonance imaging)
- nuclear medicine imaging, including positron-emission tomography (PET)
Each one uses a specific technology. They differ in how well they show what is happening in certain body tissues. For example, X-rays are often best at finding a break of a bone, whereas an MRI may be better for identifying a ligament injury. When your health professional decides what kind of imaging to recommend to you, they take the different strengths of each imaging type into account.
No type of imaging is always better. Each has different potential advantages and disadvantages, including exposure to radiation with some types of imaging. Your health professional should discuss with you which type of imaging is most appropriate for you.
- Government of Western Australia. Diagnostic Imaging Pathways. About imaging: About guidance. [Online] (accessed 30 October 2016).
- Choosing Wisely Australia. What is Choosing Wisely Australia? [Online] (accessed 30 October 2016).
A Positron Emission Tomography (“PET”) scan is an imaging test that allows your doctor to check for diseases in your body.
The scan uses a special dye that has radioactive tracers. These tracers are injected into a vein in your arm. Your organs and tissues then absorb the tracer when highlighted under a PET scan. The tracers help your doctor see how well your organs and tissues are working. The PET scan can measure blood flow, oxygen use, glucose metabolism (how your body uses sugar), and much more.
Why a PET Scan Is Performed
Your doctor may order a PET scan to inspect the blood flow, oxygen intake and metabolism of organs and tissues, they are commonly used to uncover:
- -Heart problems
- -Brain disorders
- -Central nervous system disorders
PET scans give doctors glimpses of complex systemic diseases, as they show disorders at the cellular level. Here are a few examples:
- -coronary artery disease
- -brain tumors
Risks of a PET Scan
The PET scan involves radioactive tracers, however, the exposure to radiation is minimal. According to the Mayo Clinic, radiation levels are too low to affect normal processes in your body. The risks of the test are minimal compared with the benefits the results from diagnosing serious medical conditions.
However, radiation exposure is unsafe for developing fetuses. If you’re pregnant or breast-feeding, do not get a PET scan.
How a PET Scan Is Performed
Before the scan, you’ll get tracers through a vein in your arm, a solution you drink, or in a gas. Your body needs time to absorb the tracers, so you’ll wait about an hour before the scan begins.
Next, you’ll undergo the scan. This involves lying on a narrow table attached to a PET machine, which looks like a giant letter “O”. The table glides slowly into the machine so that the scan can be conducted.
During the scan, lie still. The technician will let you know when it is that you need to remain still. You may be asked to hold your breath for short periods. You’ll hear various buzzing and clicking noises during the test.
When all the necessary images have been recorded, you will slide out of the machine.
After the PET Scan
After the test, you can go about your day unless your doctor gives you other instructions. Drink plenty of fluids after the test to help flush the tracers out of your system. Generally, all tracers leave your body after a few days.
Breast cancer is the most commonly diagnosed cancer in women. One in eight women will be diagnosed with breast cancer in their lifetime. One of the most effective ways to find and/or prevent breast cancer is through regular mammography screenings.
A mammogram is a specific type of breast exam that uses a non-invasive X-ray process that doctors use to identify and treat any abnormal areas that may possibly indicate the presence of cancer. Annual mammograms can detect cancer up to two years before a patient or physician will notice any abnormalities. Mammograms can also prevent the need for extensive treatment for advanced cancers and improve chances of breast conservation.
The Miami Center for Diagnostic Imaging now uses an even quicker and more accurate version of digital mammography. 3D mammography, also called breast tomosynthesis, is a revolutionary technology that gives radiologists the ability to identify and characterize individual breast structures without the confusion of overlapping tissue. During a tomosynthesis scan, multiple, low-dose images of the breast are acquired at different angles. These images are then used to produce a series of one-millimeter thick slices that can be viewed as a three dimensional reconstruction of the breast.
Mammograms play an important role in women’s health. They have been shown to lower the risk of dying by 35% in women over the age of 50. Breast cancer is the second leading cause of death among women; it is estimated that over 220,000 women in the United States will be diagnosed; and an estimated 2,150 men will also be diagnosed. More than 80% of breast cancers are found in women with no family history.
In addition to mammograms, women, starting at the age of 20, should make sure to schedule regular clinical exams with a health care provider; and should also perform regular self-examinations. Women at average risk for developing breast cancer should discuss with their health care provider the potential benefits of a screening breast MRI in addition to their yearly mammogram.
The digital mammography experts at the Center for Diagnostic Imaging and Comprehensive Breast Care Centers provide women with the most advanced care available to help keep them healthy.
About Center for Diagnostic Imaging:
The Center for Diagnostic Imaging Miami staff is dedicated to providing the highest level of efficient and excellent care for each patient who walks through their door. The center, known for their reputation as one of the best full body scan Miami facilities in the state, is owned and managed by physicians, radiologists, technicians, and other highly trained and qualified staff. The staff-ran facility’s mission is to serve the healthcare needs of the Miami community with the use of the most highly advanced technology medical equipment within the diagnostic imaging industry.
With this type of technology available at their fingertips, staff members have the ability to better identify any issues or concerns impacting the health and well-being of each individual patient.
The Center for Diagnostic Imaging currently offers the following scanning services:
- Computer tomography Scan (CAT Scan)
- Computed Tomography Angiography Scan (CTA Scan)
- Magnetic Resonance Angiography scan (MRA)
- Magnetic Resonance Imaging (MRI)
- Nuclear Medicine
- Position Emission Tomography Scan (PET Scan)
In addition to their diagnostic services, the center is also known as one of the most preferred breast ultrasound Miami facilities. When it comes to breast exams women the can receive 3D Mammography scans, MRI guided biopsies, and stereotactic biopsies.
and How 3D Mammography Offers Improved Accuracy
In some of our recent blogs, we have discussed how 3D mammography can be more accurate in detecting breast cancer in women with dense breasts. But, what exactly does it mean to have dense breasts?
Breast density refers to the ratio of fatty tissue to breast tissue – dense breasts have more breast tissue and less fatty tissue. Usually, the younger a woman is, the denser her breasts are, and the more difficult it is to “see” through the tissue on a mammogram to identify cancer. In fact, this is why mammograms are generally not done until a woman is 40, unless there is a history of breast cancer in her family. However, age is not the only factor. Some women can have naturally dense breasts their entire lives. About 1/3 of women over the age of 50 still have dense breasts. Continue reading