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FAQ

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Mammography

Q. What is mammography?

Mammography is x-rays of the breasts so as to enable one to detect early breast cancer

Q. Does mammography itself cause breast cancer because of radiation?

The radiation effect on the breasts decreases exponentially after 35 years of age. The only precaution to be taken is that the patient should be sure that she is not pregnant.

Q. Does the procedure of mammography cause pain?

With newer equipment very little discomfort is felt by the patient. The patient should preferably come after the period is over, as the likelihood of pain will be the least. However there will be no changes in the findings on mammography during any stage of the menstrual cycle.

Q. What is sonomammography? Why do mammography when everything is seen on sonomammography?

Sonomammography is sonography of the breasts. It is usually done as a complementary procedure to mammography. It helps in distinguishing a cystic mass from a solid mass. Cysts are usually benign. Mammography is required as the earliest of cancers are seen only on this modality.

Q. Can one definitely tell whether a mass is benign or malignant?

It is not possible to tell 100% whether a mass is benign tor malignant on either mammography or sonography. To be 100% sure, a biopsy is required. Sonography and mammography, both together are 95% accurate in diagnosing a lesion.

Q. If a close relative has breast cancer, what are the chances of a person getting it?

The chances are 5-15% if it is a first degree relative particularly on the maternal side. The person is at a high risk & should start doing mammography 10-15 years earlier than the age at which the relative got breast cancer.

Q. How does breast cancer usually present itself?

Breast cancer usually presents itself as a lump. Therefore a patient should regularly do a monthly self-breast examination particularly after the period is over. Sometimes there might be a bloody nipple discharge. Occasionally in 10% of the patients, is there is associated pain.

MRI

Q. What are some of the common applications of the MRI procedure?

For the diagnosis of a broad range of pathologic conditions in all parts of the body more specifically for the brain (including cancer, stroke), spine and musculoskeletal disorders. In addition, MRI of the heart, aorta, coronary arteries and blood vessels is a fast, non-invasive tool for diagnosing heart problems. Physicians can examine the size and thickness of the chambers of the heart and determine the extent of damage caused by a heart attack or progressive heart disease. As an alternative to traditional X-Ray mammography in the early diagnosis of breast cancer. Because no radiation exposure is involved. For examination of the male and female reproductive systems, pelvis and hips and the bladder. Specialized MRI scans.
Diffusion MRI diagnoses an ischemic stroke within 5-10 minutes of the onset of stroke symptoms. Magnetic Resonance Angiography is used to generate pictures of the arteries in order to evaluate them for stenosis (abnormal narrowing) or aneurysms (vessel wall dilatations, at risk of rupture). Magnetic resonance venography is a similar procedure that is used to image veins. Magnetic resonance spectroscopy (MRS) allows one to study a particular region within an organism or sample and provides a wealth of chemical information about that region.

Q. What does the MRI equipment look like?

The conventional MRI unit is a closed cylindrical magnet in which the patient must lie totally still for several seconds at a time.

Q. How is the procedure performed?

The patient is placed on a sliding table and positioned comfortably. Then the radiologist and technologist leave the room and the individual MRI sequences are performed. The patient is able to communicate with the radiologist or technologist at any time using an intercom. Also we allow a friend or, if a child is being examined, a parent to stay in the room.

Depending on how many images are needed, the exam will generally take 25 to 45 minutes, although a very detailed study may take longer.

Typically an MRI examination consists of two to six imaging sequences, each lasting two to 15 minutes. You will be asked not to move during the actual imaging process, but between sequences some movement is allowed. Patients are generally required to remain still for only a few seconds to a few minutes at a time.

Depending on the part of the body being examined, a contrast material (usually gadolinium) may be used to enhance the visibility of certain tissues or blood vessels. A small needle connected to an intravenous line is placed in an arm or hand vein.

When the exam is over the patient is asked to wait until the images are examined to determine if more images are needed. A radiologist will analyze the images and prepare a report with his or her interpretation.

Q. What will I experience during the MRI procedure?

MRI causes no pain. Some patients can find it uncomfortable to remain still during the examination.

Others experience a sense of being "closed in".

If a contrast injection is needed, there may be discomfort at the injection site and you may have a cool sensation at the site during the injection.

Most bothersome to many patients are the loud tapping or knocking noises heard at certain phases of imaging. Ear plugs are provided which help. For noise-reducing Avanto has a AudioComfort technology that slashes decibel levels up to 97%.

Q. Who interprets the results and how do I get them?

A radiologist, experienced in MRI and other radiology examinations, will analyze the images and prepare a report. This will be done on the same or following day. We can also provide a permanent record on a CD at a nominal additional cost. Please do inform us in advance if you need one.

Q. What are the benefits vs. risks?

Benefits
Images of the soft-tissue structures of the body are clearer and more detailed than with other imaging methods.
MRI can help physicians evaluate the function as well.
MRI contrast material is less likely to produce an allergic reaction than the iodine-based materials used for conventional x-rays and CT scanning.
MRI provides a fast, noninvasive alternative to x-ray angiography for diagnosing problems of the heart and cardiovascular system.
Exposure to radiation is avoided.

Risks
MRI is generally avoided in the first 12 weeks of pregnancy. Doctors usually use other methods of imaging, such as ultrasound, on pregnant women unless there is a strong medical reason to use MRI.
Projectiles: As a result of the very high strength of the magnetic field needed to produce scans (frequently up to 60,000 times the earth's own magnetic field effects), missile-effect accidents, where ferromagnetic objects are attracted to the center of the magnet, have resulted in injury It is for this reason that ferrous objects and devices are prohibited in proximity to the MRI scanner.
Ferromagnetic foreign bodies (e.g. shell fragments), or metallic implants (e.g. surgical prostheses, aneurysm clips) are also potential risks, and safety aspects need to be considered on an individual basis. Interaction of the magnetic and radiofrequency fields with such objects can lead to trauma due to movement of the object in the magnetic field.
Gadolinium based contrast media not to be used in patients of Chronic renal failure as it causes nephogenic fibrosis.
Thermal injury from radio-frequency induction heating of the object, Failure of an implanted device.

Preparations

There’s no special preparation necessary for the MRI examination. Unless the person at the booking counter specifically requests that you not eat or drink anything before the exam, there are no food or drink restrictions. Continue to take any medication prescribed by your doctor unless otherwise directed.

You won’t be allowed to wear anything metallic during the MRI examination, so it would be best to leave watches, jewelry or anything made from metal at home. Even some cosmetics contain small amounts of metals, so it is best to not wear make-up. There is a safe place to lock up valuables if you can’t leave them at home.

In order to prevent metallic objects from being attracted by the powerful magnet of the MR system, you will be given scrubs to change into for your examination. Items that need to be removed by patients before entering the MR system room include:

  • Purse, wallet, money clip, credit cards, cards with magnetic strips
  • Electronic devices such as beepers or cell phones
  • Hearing aids
  • Metal jewelry, watches
  • Pens, paper clips, keys, coins
  • Hair barrettes, hairpins
  • Any article of clothing that has a metal zipper, buttons, snaps, hooks, underwires, or metal threads
  • Shoes, belt buckles, safety pins

Before the MRI procedure, you will be asked to fill out a screening form asking about anything that might create a health risk or interfere with imaging. You will also undergo an interview by a technologist to ensure that you understand the questions on the form. Even if you have undergone an MRI procedure before at this or another facility, you will still be asked to complete an MRI screening form.

    Examples of items or things that may create a health hazard or other problem during an MRI exam include:
  • Pacemaker
  • Implantable cardioverter defibrillator (ICD)
  • Neurostimulator
  • Aneurysm clip
  • Metal implant
  • Implanted drug infusion device
  • Foreign metal objects, especially if in or near the eye
  • Shrapnel or bullet wounds
  • Permanent cosmetics or tattoos
  • Dentures/teeth with magnetic keepers
  • Other implants that involve magnets
  • Medication patch (i.e., transdermal patch) that contains metal foil

Check with the MRI technologist or the Radiologist if you have questions or concerns about any implanted object or health condition that could impact the MRI procedure. This is particularly important if you have undergone surgery involving the brain, ear, eye, heart, or blood vessels.

CT Scan

Q. What are the dangers of CT scanning?

Though it involves X-Ray radiations, there are no dangers in practice. Only for pregnant women, it should be done after weighing all the risks of exposing their fetus to radiations and benefits (like any other CT investigation). Dangers of contrast medium

Q. What is a 'contrast' medium?

A contrast is an iodinated compound injected intravenously (peripherally) to opacify the vessels and enhance the ability of CT scans to pick up abnormalities Only the very safest contrast (non-ionic) is used for all the patients in our centre. This gives better compliance with patients, as compared to ionic contrast, which is cheaper but, gives more adverse reactions.

 

  • Dangers of contrast medium
  • Though not so common, the contrast medium involved in a CT scan poses a slight risk of allergic reaction.
  • Most reactions result in hives or itchiness.
  • For individuals with asthma who become allergic to the contrast medium, the reaction can be an asthma attack
  • In very rare instances, an allergic reaction might cause swelling in your throat or other areas of your body
  • If you experience hives, itchiness or swelling in your throat during or after your CT exam, immediately tell your technologist or doctor. We keep an emergency kit for all commonly known adverse reactions.

Q. Who is at 'high-risk' for contrast injection?

  • Past history of reaction to contrast/any other drugs.
  • Bronchial asthma.
  • Cardiac/kidney disease /diabetes etc.

Q. Other indications your doctor may recommend a CT scan to help?

  • Diagnose muscle and bone disorders, such as bone tumors and fractures.
  • Pinpoint the location of a tumor, infection or blood clot.
  • Guide procedures such as surgery, biopsy and radiation.
  • Detect and monitor diseases such as cancer.
  • Detect internal injuries and internal bleeding.

Q. What can you expect during a CT scan?

During the CT scan, you lie on a narrow table that slides through the opening of a large device called the gantry. The table can be raised, lowered or tilted. Straps and pillows may help you stay in position. During a CT scan of the head, the table may be fitted with a special cradle that holds your head still.

As the X-Ray tube rotates around your body, the table slowly moves through the gantry. While the table is moving, you may need to hold your breath to avoid blurring the images. You may hear clicking and whirring noises. Each rotation yields several images of thin slices of your body.

During this time, a technologist in a shielded room supervises the CT scan and monitors the images as they appear on the computer screen. The technologist can see and hear you, and you can communicate via intercom.

If an infant or small child is having the CT scan, you may be allowed to stay with your child during the test. If so, you may be asked to wear a lead apron to shield you from X-ray exposure.

CT scans are painless. If your exam involves use of an intravenous contrast medium, you may feel a brief sensation of heat or experience a metallic taste in your mouth. If you receive contrast medium through an enema-to help highlight your lower gastrointestinal region-you may feel a sense of fullness or cramping.

After the exam, you can return to your normal routine. If you were given a contrast medium, your doctor or the radiography staff may give you special instructions. These likely include drinking lots of fluids to help remove the medium from your body.

Sonography

Q. What is sonography?

Sonography, or ultrasound, utilizes high frequency sound waves (not x-rays) to obtain diagnostic images. Ultrasound imaging is used to evaluate many parts of the body, including the abdomen, blood vessels, fetus of pregnant women, superficial body structures, and newborn brain to name only a few.

Q. What is TVS?

It is a sonography done for better visualisation of uterus & ovaries. A high-resolution endovaginal probe is inserted into the vagina for this examination. It is not painful. It is done as a routine at our centre as it is observed that at times, even fairly prominent lesions can be missed if only trans-abdominal sonography is performed. It does not require a full bladder.

Q. Is expected date of delivery and weight estimation 100% accurate?

Expected date of delivery and weight estimation are just estimates based on statistical data of the baby size. It is not 100% accurate but, predicts the dating and weight estimation up to +/- 10%.

Bone Densitometry

Q. What happens during the scan?

There is no special preparation required for the scan. All it involves is the lying on a table, breathing normally. No intravenous injections or oral medication. The intensity of radiation is extremely low. The whole procedure takes about 10 minutes.

Q. Why Physicians Request a DEXA Exam?

  • To determine your actual bone density and fracture risk.
  • To reveal early signs of bone loss with the fewest false positive or false negative results.
  • To diagnose low bone mass that may signal the need for treatment.

Neurology

Q. How significant is the radiation in an X-ray?

The average amount of exposure to an X-ray is very low and is well within the acceptable amount recommended.

Q. What does one do if an X-ray is required during pregnancy?

The X-ray technician should be informed and he should cover the lower abdomen with a lead apron. In case one's pregnancy status is unknown, it is still a good idea to ask for protective cover.

Q. Isn't barium awful to taste?

No, at Star Imaging, it is pleasantly flavored.

Q. How long does a barium test take to perform?

An upper G.I. series takes 30 minutes. A full study takes 3-4 hours.

Q. In these days of hi-tech investigations, are X-rays getting redundant?

No, X-rays are the most cost-effective means of diagnosis, particularly when diseases of chest, bones & joints are concerned.

Cardiac CT

Q. What is CORONARY ANGIOGRAM?

Coronary angiogram is an invasive procedure, where a tube will be inserted inside your body through a puncture in your leg artery or arm artery. Serial X-ray pictures are taken after injecting iodine containing medicine into your heart vessels. This procedure is painful and requires admission.

Q. Is there any alternative to diagnose CAD without pain and hospitalization?

Yes, CT Coronary Angiogram is the New gold standard method for Coronary Artery Disease to diagnose without pain and hospitalization.

Q. Does CT Coronary Angiogram give the same results as that of catheter coronary angiogram?

Surely, Yes, CAD Coronary Angiogram has 99% negative predictive value. Also, it has a very high specificity about the type of atherosclerotic plaques (deposits) and can differentiate them into calcified, soft and mixed types, which is not possible with catheter angiogram.

Q. Who should get their CT Coronary Angiogram test done?

If you have any of these under mentioned risk factors, you need a CT Coronary Angiogram:-

  • High blood pressure more than 130/90 mm Hg.
  • Diabetes.
  • High Cholesterol.
  • Family history of heart disease.
  • Smoking.
  • Sedentary life style.
  • If you are obese or your body weight is more than 20% of recommended weight.
  • High Stress jobs.
  • Men above 40 years and women above 45 years.

 

Q. There are other conditions such as,

  • To assess the patency of grafts.
  • To assess the function of stents.
  • Post Exertional chest pain or breathlessness, you may need this test.

Q. How CT Coronary Angio is done?

As explained earlier CT Coronary Angio is a totally non-invasive (painless) procedure. You will be taken to the CT scan room, after routine ECG and blood tests to exclude kidney problems. You may lie flat on the CT table and an intravenous line will be inserted in to one of your arms veins. If you chest is hairy we need to shave over a little area of the chest, to fix the ECG leads. You will be given a tablet to control your heart rate, which will be prescribed by our cardiologist after taking your ECG or Echocardiography. You will be instructed to hold breathe during scan. Your scan is done by CT equipment along with ECG gating. During the scan non-ionic contrast medicine will be injected through the arm vein, which may give you a slight warm sensation.

Q. How long does it take for CT Coronary Angiogram?

The actual scan takes less than 5 seconds. But, you need to be prepared for the scan which takes 30 minutes to 1 hour. So, your stay in Star Imaging & Path Lab can range from 1-2 hours.

Q. Is there any risk in undergoing this investigation?

Like conventional angiogram CT Coronary angiogram also uses X-ray radiation. But, the levels of radiation used are minimal below any harmful levels. Further, the latest Optima 500 Slice Scanner at Star Imaging & Path Lab has unique prospective cardiac scan module which reduces the radiation exposure to less than 50% to 80% in comparison to other equipments.

Q. What all the other scans we can combine with CT Coronary Angiogram in addition?

CT Coronary Angiogram with CT Chest.

CT Coronary Angiogram with CT Abdomen.

CT Coronary Angiogram with Renal Angiogram.

CT Lower Limb Angiogram.

CT Coronary Angiogram with Neck Vessels.

CT Coronary Angiogram with Whole Body Angiogram.

Preparations

Your doctor will tell you how to prepare for the cardiac CT scan. People usually are asked to avoid drinks that contain caffeine before the test. Normally, you're allowed to drink water, but you're asked not to eat for 4 hours before the scan.

If you take medicine for diabetes, talk with your doctor about whether you'll need to change how you take it on the day of your cardiac CT scan.

Tell your doctor whether you:

  • Are pregnant or may be pregnant. Even though cardiac CT uses a low radiation dose, you shouldn't have the scan if you're pregnant. The x rays may harm the fetus.
  • Have asthma or kidney problems or are allergic to any medicines, iodine, and/or shellfish. These problems may increase your chance of having an allergic reaction to the contrast dye that's sometimes used during cardiac CT.

A technician will ask you to remove your clothes above the waist and wear a hospital gown. You also will be asked to remove any jewelry from around your neck or chest.

Taking pictures of the heart can be hard because the heart is always beating (in motion). A slower heart rate will help produce better quality pictures.

If you don't have asthma, COPD (chronic obstructive pulmonary disease), or heart failure, your doctor may give you a medicine called a beta blocker to help slow your heart rate. The medicine will be given by mouth or injected into a vein.

Cardiology

Q. How is the test carried out?

A stress test or treadmill test or exercise records the heart's electrical activity (rate and rhythm) during exercise.

  • Prior to the test electrodes will be placed on the chest (same as ECG) and patient is hooked up to equipment to monitor the heart
  • Prior to the test you may be asked to breath rapidly hyperventilate) for a while
  • The patient will be asked to walk on a motorised treadmill
  • The speed and inclination of the treadmill will be gradually increased
  • The doctor will be looking for changes in ECG pattern, will check Blood Pressure in between and will be enquiring about any symptoms that patient may experience
  • The patient may be on treadmill for up to 15 minutes, depending upon his level of exercise, recovery and cardiovascular condiovascular conditioning
  • The test will be stopped if the patient becomes too tired, has any symptoms such as chest pain

 

Q. What happens after the test is done?

After the test patient will be asked to sit or lie down till heart and blood pressure recovers to baseline. The stress test doctor will then evaluate the data collected through the test and make the necessary recommendations

Q. How long does a normal stress test take?

The total time required for the test will be about 30 minutes.

Q. Is there any risk in taking the test?

There is very little risk in taking the test in healthy person - no more than if a person walks fats or jogs up a big hill. During the test the cardiologist and a technician are always present.

Q. Why is a stress test done?

To find out:

  • How hard the heart can work before symptoms develop.
  • How quickly the heart recovers after exercise.
  • The patients overall level of cardiovascular conditioning.

 

Q. Is it necessary to take a prior appointment?

Prior appointment will save considerable time on the day of test.

Radiology

Q. What does one do if an X-Ray is required during pregnancy?

The X-Ray technician should be informed and he should cover the lower abdomen with a lead apron. In case one's pregnancy status is unknown, it is still a good idea to ask for protective cover.

Q. How long does a barium test take to perform?

An upper G.I. series takes 30 minutes. A full study takes 3-4 hours.

Q. In these days of hi-tech investigations, are X-Rays getting redundant?

No, X-rays are the most cost-effective means of diagnosis, particularly when diseases of chest, bones & joints are concerned.

Q. How significant is the radiation in an X-Ray?

The average amount of exposure to an X-Ray is very low and is well within the acceptable amount recommended.

Pathology

Q. Do you offer home visit for blood collection?

Yes, with prior notice, we send technicians for home visits within the vicinity of our 3 centres.

Q. Do you use disposable collection device?

Yes, for every patient, fresh blood collection device is used which is then disposed with due precautions.

Q. When can I get the report?

90% of the reports can be given on the same day in the evening and, certain specialized investigations can be done in a day or two.

Q. Is Fasting required for routine investigations?

Yes, fasting is required for most of the routine hematology and biochemical investigations unless otherwise specified by the doctor.

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