During an X-ray, MRI, CT scan or other medical imaging procedure, patients are often expected just to follow instructions—sit there, lie there, turn this way, hold this, don’t move. Afterward, they are expected to be on their way with some vague feeling that their doctor will eventually look at the images and be in touch if they reveal anything serious. Here at Reno Diagnostic Centers, however, we’re about transparency (in more ways than one!) and encourage our patients to fully understand their health care experience.
So what is happening while you’re getting your exam? What happens to the images afterward? When you trust us to be your diagnostic services provider, we want you to get the best possible care and understand why we do what we do—from the scan itself to the process of getting your scans safely and confidentially to your primary care physician or specialist.
How We Take Your Medical Images
X-ray and Digital Fluoroscopy
In the most basic terms, during an X-ray, we isolate a specific part of your body and send a very small and safe amount of radiation to it. The radiation imprints the images of that area of your body onto digital plates. You feel no pain whatsoever. X-rays are important in revealing conditions such as broken bones and signs of cancer, pneumonia and other conditions.
Our technologist will ask you to position your body in a way that ensures the X-ray machine can get the views the doctor needs. He or she may help you achieve those positions by moving your body. He or she may use lead aprons to help you maintain position and shield other parts of your body from unnecessary exposure while the machine does its work. You could also be asked to hold your breath for the actual moment of the X-ray to minimize movement, and you certainly will be asked to remain as still as possible during the procedure.
Some procedures require a contrast medium, an oral or injected “radiocontrast agent,” that helps improve the visibility of your bodily structures for the X-ray machine. If your procedure requires this, the technician will provide the contrast to you as an injection or orally. These injections serve to intensify the contrast of your organs and any diseases you may have. This helps your radiologist and doctor provide a more accurate diagnosis.1 Most bone X-rays do not take long, but if an X-ray involves using a contrast medium, it could take up to an hour.
We also offer digital fluoroscopy, which differs from X-rays in that we can access motion in your body, allowing doctors to see organ function and make diagnoses based on dynamic processes they observe. Fluoroscopy manages this by taking images at a very high frame rate—up to 30 images every second. More images do not mean more radiation, though; RDC’s state-of-the-art equipment keeps the radiation dose very low during fluoroscopy procedures.
Digital fluoroscopy is often used to visualize functions such as digestive tract or to help with catheterization. It typically involves the use of oral contrast medium. The process for a fluoroscopy session will be much the same as that for a regular X-ray.2
Magnetic Resonance Imaging (MRI)
In layperson’s terms, an MRI machine is a large tube ringed with powerful magnets. During the scan itself, the magnets form strong magnetic fields, and, along with radio waves inside the tube, they produce very detailed scans of your body’s interior structures. The more technical explanation involves using the powerful magnets to line up all the protons in your body’s water molecules in the same direction, than knocking them out of alignment with short bursts of radio waves. A radio receiver picks up the exact location of all the protons in your body, which are then combined to create a detailed digital image, much like individual pixels on a computer screen.
Your doctor may order an MRI for conditions potentially affecting your brain, spinal cord, bones, joints, heart and blood vessels, breast tissue, liver, prostate gland and other internal organs.
You might have seen images of an “MRI tube” before, where a person lies supine on his or her back on a flat bed that moves into the round opening of the scanner. You will be given a medical gown to change into, and our technician will talk to you about what to expect from the entire procedure before you are put into the MRI tube. Depending on what part of your body is being scanned, you will be moved into the tube with either your head or feet going into the opening first.
You will be asked to keep very still during the MRI procedure. Scans can last from 10 minutes to 50 minutes depending on why you are receiving a scan and how many images must be taken. Since MRIs can be used to help with diagnosis and treatment for many conditions, this time can vary quite a bit. You will be able to speak to the radiographer through an intercom during the procedure, and he or she will be able to see you inside the tube on a screen outside the scanner. You’ll also be provided with headphones or earplugs because the machine can make loud tapping noises as the electric current in the scanner coils turns on and off.
Getting an MRI is a completely painless procedure, and some patients find it to be a peaceful experience. We also understand, however, that some patients may be hesitant to be inside a small space for long periods of time, and our technologists, nurses and radiologists are all trained to work with you to make you as comfortable as possible while also making sure your doctor receives the information to help with your diagnosis and treatment.3
Computed Tomography (CT) and Positron Emission Tomography (PET)
We introduced the use of PET technology in northern Nevada more than fifteen years ago, and today we offer both types of scans, PET or PET/CT. PET is the highest standard for organ scans for cancer and brain function evaluation.
A typical CT scan involves lying on a narrow table that moves into a scanner, similar to the experience of an MRI. While you lie still, an X-ray beam rotates around you in a spiral, taking images, or “slices,” of different areas of your body. These are then converted into 3D models after the scan, which provide more information than 2D scans.4
The combination PET/CT scan requires the use of a radiopharmaceutical (FDG) that gathers in the organs your doctor needs to examine on the scan. The isotope helps the machine collect better images of your organs or area by increasing contrasts. The PET scanner detects energy waves from your body and converts that energy into electrical signals to pinpoint the location of organ structures and pathology, creating a 3D image of the organ.
PET/CT scans have significant advantages over CT scans alone because they show organ function in addition to anatomy. The more metabolically active the organ in question, the more its energy will show up on the scanner, thanks to the radiopharmaceutical isotope.5 These scans are some of the latest ways physicians diagnose and manage cancer.
Mammography and 3D Mammography
You might not be aware of how much choice you have when it comes to mammograms. Many consider 2D digital mammograms the only game in town. These types of breast exams often are perfectly adequate for women with few pre-existing risks or any particular reason to suspect breast issues. This exam consists of having our technician gently place your breast between two plates to stabilize it (you may feel some pressure during this part of the exam), followed by the digital mammography scanner taking two-dimensional images, usually from set positions such as the top and sides.6
For women at higher risk for breast cancer or for women with dense breast tissue that could obscure lesions, the best technology is undoubtedly 3D mammography, also known as tomosynthesis. In this type of scan, the machine takes many images at many angles—“slices” like in the CT scan—and recreates a full 3D image of the breast tissue that often helps eliminate hidden spots. A 3D scan also results in less squeezing of the breast because it does not have to be flattened as much for the scanner, which means less potential discomfort during the procedure. 3D mammography is still the most state-of-the-art mammography in the United States, and multiple studies show 3D mammography increases breast cancer detection by 30% and decreases callbacks by 40 to 50%.7 RDC began offering 3D mammograms in early 2015.
What Happens to Your Images After You Leave the Exam Room?
After you finish your exam, the technician will process your images. This can involve digitizing them and possibly even using special software to convert 2D images into 3D ones, depending on which scans you received and why your doctor ordered them.8
One of our highly trained and certified radiologists will then review your scan within a short timeframe and provide your doctor with a timely report.
Patients are sometimes curious about why they can’t always wait a few minutes after their exam and speak directly to the radiologist about the results, or simply take the scans with them when they leave.
Although the scans are not immediately available to you, we evaluate scans promptly and communicate quickly with your primary care physician or specialist. Scans are highly sensitive and private medical information. The images and report are available to you once completely processed.
Radiologists are doctors who receive five to seven years of additional training after medical school. They are highly trained to interpret all kinds of scans, and they work as part of your health care team. They will consult with your physician or specialist to make sure they have the correct context for your situation, including the reasons why the scan was ordered and any other pertinent medical information.
Typically, your radiologist will not discuss your scans with you because it’s much more likely that your primary physician, or, at least, the specialist who ordered the scan, will have a more complete picture of your health situation and be able to speak to you about the results and put the imaging results in context with your other medical and physical findings. The ideal scenario for patient care is a skilled radiologist who communicates quickly with your physician, which we pride ourselves on doing.9
We offer many other diagnostic services beyond the more common ones we’ve discussed here, and we encourage you to contact us or ask questions about these services. The next time your doctor recommends or orders any diagnostic service or medical imaging exam for you, treat it as an opportunity to learn more about the processes surrounding your health care experience. Talk to your doctor about why he or she has asked for that procedure. What will it tell them? Are there other options? And of course, always feel free to talk to us, your medical imaging expert, about our services as well.
- “X-ray: What you can expect,” March 26, 2015, http://www.mayoclinic.org/tests-procedures/x-ray/basics/what-you-can-expect/prc-20009519 ↩
- “Modern Fluoroscopy Imaging Systems,” Nov. 25, 2014, http://www.imagewisely.org/imaging-modalities/fluoroscopy/articles/gingold-modern-systems ↩
- “MRI scan,” July 10, 2015, http://www.nhs.uk/conditions/MRI-scan/Pages/Introduction.aspx ↩
- “Computed Tomography (CT) Scans and Cancer,” July 16, 2013, http://www.cancer.gov/about-cancer/diagnosis-staging/ct-scans-fact-sheet ↩
- “PET scan,” Oct. 22, 2014, https://www.nlm.nih.gov/medlineplus/ency/article/003827.htm ↩
- “Digital Mammograms: A Clearer Picture,” July 20, 2015, http://www.webmd.com/breast-cancer/tc/digital-mammograms-a-clearer-picture ↩
- “3-D Mammography Test Appears to Improve Breast Cancer Detection Rate,” June 24, 2014, http://www.nytimes.com/2014/06/25/health/breast-cancer-3d-mammography-test-x-ray.html?_r=0 ↩
- “Converting 2D Technology Into 3D Imaging,” Aug. 12, 2010, http://www.mdtmag.com/article/2010/08/converting-2d-technology-3d-imaging ↩
- “Should radiologists discuss results with patients?” Dec. 22, 2014, http://www.kevinmd.com/blog/2014/12/radiologists-discuss-results-patients.html ↩