Archive for ‘CT/CAT scan’

February 9, 2016

Centered on the Inner Athlete in YOU!

June 17, 2015

Knock Out Lung Cancer with Low Dose CTs

Patient-Flyer---Lung-CT-UMKC

August 21, 2014

Head Aches, Head Issues #3: CT Scan of the Head

CT scan by NithinRao via Wikimedia Commons Copyright Public DomainSo if you’ve had a good wallop to the head (or it just feels like you have) your doctor may direct you to a head CT.

 

Like all CTs, a modifiable dose of radiation is used to image the body in “slices” which are then reconstructed into images. Use of radiation in pregnancy should be reserved for special cases, so let the technologists know if you are or could be pregnant.

 

What To Expect

 

Before a CT of the head, no special preparation is necessary. However, metal interferes with the images, so jewelry, hairpins and the like will need to be removed from the region of the head.

 

The procedure takes approximately ten minutes with only the head moving through the machine. Persons with claustrophobia typically do well with CT because the exam is fast and the machine itself is not too confining. Holding still is important – as with all images, motion causes blurring.

 

CT of the head is often performed without contrast. For cases following trauma or in an evaluation for headache a non-contrast examination may be sufficient.  There are times when IV contrast injection is necessary. This additional part of the study can be very helpful to evaluate the blood vessels in the head and for assessment of the brain tissues and its enhancement. The iodinated contrast material will be given thru an IV which may cause a feeling of warmth. Images are then taken in the same manner as the initial non-contrast series.

 

What Happens Next

 

After your exam is completed, the images are studied by your radiologist for interpretation and reporting. The results are then shared with your referring doctor to integrate the new information gained from your head CT with clinical symptoms for a specific diagnosis.

 

On Your Way!

 

That’s it! A CT head is a quick, simple procedure which can be invaluable in looking at your brain and surrounding tissues. It can help get you on your way to being headache- and anxiety – free!

 

 

(Image credit: CT scan by NithinRao via Wikimedia Commons Copyright Public Domain)

 

 

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

June 25, 2014

Lung Cancer Screening Gets Another Leg Up

Symbol kept vote Green by Zorglub via Wikimedia Commons Copyright Creative Commons Attribution-Share Alike 3.0 UnportedThe votes in support of low-dose screening CT chest for high risk smokers are growing. Recently the American Medical Association – the largest association of doctors from all specialties in the US – added their support to guidelines recommending this potentially life-saving exam.

 

Lung cancer is a killer. In the US, lung cancer causes more deaths than breast + prostate + colon cancer – more deaths than all of those cancers combined! Studies on low-dose CT screening (the National Lung Screening Trial) showed early detection saves lives! There was a 20% reduction in deaths in heavy smokers from lung cancer due to CT screening in this study. This is why low dose chest CT is so crucial. Finding lung cancer early, when it is potentially treatable is the goal of screening.

 

As accredited members of the American College of Radiology, we are thrilled that the ACR is fighting to support the recommendations of the United States Preventative Services Task Force for high-risk patients. (Read all about it here.) The Task Force recommended coverage beginning January 2015 for high risk patients, including those 55-80 years with significant smoking histories (defined as greater than a 30 pack-year history of smoking) or for those who were former heavy smokers who have quit in the last 15 years. The Task Force recommendations will apply to those patients with insurance.

 

The fight for coverage of Medicare patients is still on-going, and is the focus of the ACR and other groups. The Medicare Evidence Development and Coverage Advising Committee made a controversial stand against support of low-dose CT screening early this year. Medicare will make its final vote in the fall. We think including Medicare patients in coverage for this important, potentially life-saving exam is crucial.

Make your voice heard – add your vote in favor of low-dose screening CT chest for all who will benefit- including Medicare patients! Contact your local congresspersons (here) and let them know you agree.

(Image credit: Symbol kept vote Green by Zorglub via Wikimedia Commons Copyright Creative CommonsAttribution-Share Alike 3.0 Unported)

 

Diagnostic Imaging Centers blogs on regularly about women’s health atwww.mammographykc.com and general radiology atwww.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

June 11, 2014

Vascular Series Part 2 – What Is CT Angiography (CTA)?

CTACT angiography, or computed tomography angiography, (now you see why we like to call it CT angiography- such a mouthful!) is a way of imaging the blood vessels and surrounding tissues.

 

Why would we do that? CT angiography is a noninvasive way to exquisitely evaluate blood vessels within the body. With a simple venous injection of contrast we can quickly and elaborately evaluate the artery, the wall of the artery and the surrounding tissues.  Let’s look at an example. Say we need to evaluate patients with suspected narrowing in the neck arteries – CT angiography may follow an abnormal carotid Doppler to confirm how narrow the vessel is and to see if surgery will be necessary. It will show calcifications and noncalcified plaques and show how they affect the lumen (inside of the vessel) of the artery. This test is helpful in planning any necessary surgeries.

 

CT angiography can also be used to look at the arteries in the head for patients with strokes from bleeds. Aneurysms  (focal outpouchings) and their relation to the vessel are well seen and this procedure can help plan interventions needed to address them.

 

So now we know why we need to perform CT angiography, it begs the question, why is this modality of imaging the best choice for a situation? In the past, catheter angiography was the traditional way of imaging blood vessels of all types. However, it involves  putting a catheter through the skin into vessels, usually with an approach through the groin or in the arm. This creates beautiful images of the insides of the vessels, but is associated with some risks related to the catheter and the arterial puncture.

 

CT allows us to get exquisite images of the vessels with an injection into a vein in a less risky fashion while also allowing us to see the blood vessel wall – not just the lumen as is seen in traditional angiography. CT angiography can be used to evaluate blood vessels from the head to the toes and most parts in between.

In some cases, CT angiography has replaced or nearly replaced the need for catheter angiography (CT angiography chest to evaluate for pulmonary emboli or blood clots in the vessels in the lungs is one example). Other times, CT angiography will identify those patients that will benefit from catheter angiography – often this is used when interventions like angioplasty (ballooning narrowed areas in the arteries) or stenting (putting in metal or mesh stents to open up narrowings) are needed.

 

All told, CT angiography may be a lot of syllables but it can save a lot of lives.

Diagnostic Imaging Centers blogs on regularly about women’s health atwww.mammographykc.com and general radiology atwww.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

May 1, 2014

Lung Cancer Screening and (New) Recommendations

smoking kills by André Hengst via Flickr Copyright Creative Commons Attribution-NonCommercial-ShareAlike 2.0 Generic (CC BY-NC-SA 2.0)When it comes to cancer, lung cancer leads the list of the most deadly for men and women in the US. Fighting this disease has been an uphill battle, impeded by the fact that most patients are not diagnosed until late in their disease. Having an effective screening test to identify lung cancer when it is small and treatable has been a goal for years – the development of low-dose CT chest for the screening for lung cancer has brought hope.

 

We are therefore profoundly disappointed that the Centers for Medicare & Medicaid Services (CMS)’s Medicare Evidence Development and Coverage Advisory Committee (MEDCAC) did not vote to recommend Medicare coverage of low-dose CT screening. Their primary concern is not that is does not find cancer, but that it will find too many things that are not cancer.

 

We disagree with the CMS, as do other (more important!) groups in the US. The United States Preventative Services Task Force (their statement can be found here) recently recommended coverage. This is critical, as those preventive services deemed appropriate by the Task Force are mandated to be covered under the Affordable Care Act. What does that mean? A double standard – those with health insurance will be covered, those with Medicare will not if the CMS acts on the recommendations of their advisory committee.

 

One of the (many!) advocates of low-dose CT screening is the American College of Radiology (their statement can be found here). The ACR supports the use of screening CT chests in those patients at the highest risk – in other words, heavy smokers or heavy former smokers. The National Lung Screening Trial found that there was a 20% reduction in deaths for heavy smokers due to screening (the trial report can be found here). That’s no small number. The ACR is working on developing uniform guidelines to help with interpretation and to reduce the number of false findings – those that seemed to concern the Advisory Committee.

 

Luckily, the CMS is not bound by the recommendations of MEDCAC and action based on the recommendation isn’t expected until late fall of this year. We hope that reevaluation of the data occurs between now and then, so that Medicare patients are covered.

 

If you’d like to know more about lung cancer and what you can do about it, we recommend checking out Free to Breathe. Eliminating the use of tobacco is a larger goal which will more profoundly affect lung cancer in the US – if you smoke, get help to stop.

Imagine attribution: smoking kills by André Hengst via Flickr Copyright Creative Commons Attribution-NonCommercial-ShareAlike 2.0 Generic (CC BY-NC-SA 2.0)

Diagnostic Imaging Centers blogs on regularly about women’s health atwww.mammographykc.com and general radiology atwww.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

March 4, 2014

Effective, Cost Effective, Life-saving CTs

Lung cancer is the leading cause of cancer deaths in the United States. The number of people dying from lung cancer in the US per year is greater that the number of deaths from breast, prostate and colon cancer combined. Despite the scope of the problem of lung cancer, early detection has been the subject of debate. Recent studies have shown that low-dose CT screening for lung cancer in high-risk smokers can reduce cancer deaths. The detection of small lung cancers before spreading outside the lungs has been shown to save lives.

According to a newly published study, there’s more good news about CT lung screening for smokers age 55-75. This study shows the success of CT screening out in the communities – not just in academic centers. Naturally, the best way to save lives from lung cancer is to never use tobacco or to stop using it. But as long as patients are fighting the uphill battle for lung health, it is keenly important to fight it on all fronts, from prevention to early detection.

For successful lung cancer screening, CT scans must be “low dose”, referred to as LDCT. We are always conscious of and try to limit radiation dose wherever possible in our practice. The principle of imaging is using the lowest dose possible to achieve the images we need. Studies have shown we can safely use LDCT for early detection of lung cancer. This study in particular shows that low dose CT programs can hit the trifecta of helpfulness: they are effective in finding lung cancer, can be performed cost-effectively and can save lives. There you have it.

The January recommendation from the US Preventative Services Task Force said that high-risk patients could benefit greatly from regular low-dose CT screenings. This is timely news as the US Centers for Medicare and Medicaid Services are currently determining coverage feasibility. This recent study shows that execution and efficacy are possible!

Hopefully, we will be seeing programs develop and expand as a result of these findings. For those at high risk, lung cancer screening with low dose CT and early detection can be life changing and life saving.

February 14, 2014

Heart Health: CT Coronary Angio

Here is an image from a CT coronary angiogram showing the aorta (the main blood vessel coming out of the heart and bringing blood to the body) with the coronary arteries coming off the aorta and going around/to the heart – the heart has been removed from the image so we can see the vessel, much like is seen on a heart catheterization. These arteries show no significant narrowings.

Here is an image from a CT coronary angiogram showing the aorta (the main blood vessel coming out of the heart and bringing blood to the body) with the coronary arteries coming off the aorta and going around/to the heart – the heart has been removed from the image so we can see the vessel, much like is seen on a heart catheterization. These arteries show no significant narrowings.

Now that we’ve covered CT coronary calcium scores, we’d like to talk more about noninvasive heart imaging.

There are several ways of studying artery narrowing or blockages of the coronary arteries of the heart. Two common exams are the CT angiogram of coronary arteries and the coronary angiogram, also known as a heart catheterization or “heart cath.”

For a CT angiogram, radiologists use CT technology and intravenous contrast to noninvasively image the arteries. A heart catheterization, usually performed by a cardiologist, uses a small catheter threaded through the blood vessels to the heart to inject contrast into the arteries.  The exam may require light sedation, and the use of catheters in the heart has risks including but not limited to blood vessel damage, arrhythmias, bleeding and stroke.

It has been shown that 40% of heart catheterization procedures in women and a smaller percentage in men are normal.  In those cases, nothing is wrong with the arteries and nothing requires treatment like angioplasty or stenting.  Having a less invasive, safer exam to evaluate people at risk for heart disease or symptoms of heart disease is a bonus – particularly for those patients with lower risk and potentially normal coronary arteries.

CT angiography of the coronary arteries uses CT, EKG, intravenous contrast and sophisticated 3D post processing techniques to create 3D images of the heart and heart arteries for analysis. Both soft plaques and calcified arterial plaques can be imaged and analyzed for severity. The determination for noninvasive or invasive treatments can be made from this study. The  procedure takes approximately 30 – 60 minutes, requires little preparation and the results are shared with the ordering physician for further review.

For patients at high risk for coronary artery disease, or those likely needing intervention such as angioplasty (treating narrowed arteries with a balloon) or stenting, a traditional heart catheterization is recommended. This allows diagnosis to be followed by immediate treatment.

CT coronary angiography can be considered for the following patients among others:

  • Patients with a strong family history of heart disease.
  • Patients with multiple risk factors for heart disease such as hypercholesterolemia, hypertension, diabetes.
  • Patients with atypical chest pain.

Talk to your medical provider if you have questions regarding this examination or questions regarding your personal risk for heart disease.

October 29, 2013

A Blood Test for Lung Cancer

We’re fans of whole-body health and that means all the parts… but we’ve been keen on lungs lately. Who needs a good reason? We all enjoy breathing.

Biopsie Lunge Computertomographie BC by Hellerhoff (via Wikimedia Commons) Copyright  Creative Commons Attribution-Share Alike 3.0 Unported license

We’ve talked about the power of CT for lung cancer diagnosis (here and here) and even covered the topic of smoking-related breast cancer risk over on our mammography blog (here). Today we’d like to talk about more good news in the world of lung health: a potential alternative to current management of lung nodules found on a CT scan. Lung cancer is currently the leading cause of cancer death in the US – for men and women.

While the research (and technology) is still in the early phases, it looks like a promising future in the search (and hopefully destroy) mission for early detection of lung cancer. In a study published on October 16th in the journal Science Translational Medicine, a new blood test was unveiled that can aid in finding lung cancer in a minimally invasive manner. The article is a heady read, so we’re going to break it down for you:

If a patient has a lung nodule, the current next step is often a biopsy, possibly with surgery or imaging guided. This new blood test screens for a select set of proteins that can help determine if the nodules are benign or cancerous.  So, a normal blood test could potentially save a person from undergoing a biopsy or alternatively might lead doctors to surgery at an early treatable stage.

Working in a scientific field, we know that further studies must confirm the initial positive results before anyone can shout this as a revolution. But we are thrilled and optimistic that there’s progress being made in early detection of lung cancer – because early detection saves lives.

Additional reading here.

October 24, 2013

What preparation is required for a CT scan? Will I need to get an IV? with Dr. Scott Sher