Radiology

Cherokee Regional Medical Center's Radiology Department has a staff of highly-trained individuals specializing in diagnostic imagining. They use their training and state-of-the-art equipment to identify structural and functional abnormalities in the body.

The Radiology staff is available 24 hours a day and all registered by the American Registry of Radiologic Technologists and have completed other specialty training.

A board-certified radiologist reviews and interprets each exam.

Radiology Services Available at CRMC:

Bone Densitometry

Bone density testing is most commonly used to detect and evaluate the advance of osteoporosis in post-menopausal women. Osteoporosis involves a gradual loss of calcium, causing the bones to become thinner, more fragile and more likely to break.

The DXA machine sends a thin, invisible beam of low-dose x-rays with two distinct energy peaks through your bones. One peak is absorbed mainly by soft tissue and the other by bone. The soft tissue amount can be subtracted from the total and what remains is a patient’s bone mineral density.

Most often, doctors focus on bone loss in the spine and hip where most osteoporosis-related fractures happen. During an examination of the spine, your legs will be supported on a padded box to flatten your pelvis and lower (lumbar) spine. To assess your hip, the technologist will place your foot in a brace that rotates the hip inward.

CT Scan

Computed tomography, more commonly known as CT or CAT scanning, is a sophisticated imaging technique that can show anatomy at different levels within the body. During CT imaging, the x-ray source rotates around the patient and each rotation produces a single cross sectional “slice” (like a slice in a loaf of bread). CT allows physicians to see a horizontal piece of the body, just as if you were taking a slice of bread out of a loaf.

CT scans are used to diagnose many conditions. They may be used to examine the head to check for bleeding, tumors, blood clots or signs of a stroke. In other parts of the body, CT may be used to tell whether a growth is solid or fluid-filled, determine an organ's size and shape and evaluate many different diseases.

Mammography

Mammography is simply an x-ray that provides the sharpest images available of the breast's inner structure. The advanced screening capability of a mammogram greatly improves the survival rate of women because it helps the physician to detect much smaller tumors than those that can be felt by self-examinations alone

Cherokee Regional Medical Center utilizes the Hologic Selenia™, a full field digital mammography system.The system gives CRMC cutting edge diagnostic capabilities. The Hologic Selenia ™ provides patients with optimal breast imaging and comfort. Unlike film-based mammography, digital mammograms produce images that appear on the technologists monitor in a matter of seconds. No waiting for film to develop, which can mean a shorter time spent in the breast imaging suite. Also, it is designed to reduce the discomfort often associated with mammography as well as provide detailed electronic images while actually reducing the amount of x-ray dosage the patient receives.

MRI

Magnetic Resonance Imaging (MRI) is a technology that creates images for a radiologist to interpret from the water in the human body. Giant magnets allow the patient's body to receive radio waves and “echo” them back. A computer uses the information within the echoes that bounce back from the body to create images. There is no exposure to X-ray radiation. The images created are unique to the patient, depicting their anatomy and any disease that may be present. The whole process is safe and painless. Some patients are so comfortable inside of the magnet that they actually fall asleep while this imaging magic takes place.

MRI “sees” right through bone, and clearly pictures soft tissue. MRI is especially valuable for helping to diagnose brain and nervous system disorders, cancer and musculoskeletal problems.

Nuclear Medicine

Unlike x-rays that produce a structural image of an organ, nuclear medicine scans produce an image of the organ's function. In other words, images produce by nuclear medicine scans tell what part of an organ is working correctly, and what part is not.

In conventional x-ray or CT exams, radiations comes out of a machine and passes through the patient's body. In nuclear medicine exams, however, a radioactive amterial is introduce into the patient's body, usually by injection, and is then detected by a machine.

The amount of radioactive material introduce into the body is carefully measured to reflect the patient's age, weight and other variables, so it is very safe. Also, the radioactive material is only inside the body for a very short time because it decays rapidly.

Types of nuclear medicine scans available:

1. HIDA Scan:
A hepatobiliary scan (HIDA scan) is done to evaluate the function of the liver in making and excreting bile, and the drainage system (bile ducts) and gallbladder for possible blockage or malfunction. This will frequently be done together with gallbladder ultrasound for a more complete evaluation.
2. Heart Scan:
There are several common names of just two types of heart scans available in nuclear medicine, which show different aspects of the heart's function and structure. With all heart scans, the injection is given into a vein. The kind of scan you may undergo is determined by what specific information your doctor is seeking.

A Gated Ventriculogram or MUGA is used to evaluate Left Ventricular Ejection Fracture (heart function). This test is often done before receiving chemotherapy. You will receive one injection of Pyrophosphate (PYP) which tags to red blood cells. After 15-20 minutes, you will receive another injection of radioactive isotopes which tags to the PYP and red blood cells. You will lie on a table where you will be connected to a monitor. Three sets of images will be taken, each set lasting approximately ten minutes.

The blood flow scan (Cardiac Stress Test, Thallium Treadmill Study, Cardiac SPECT Scan, Myocardial Perfusion) is usually performed in conjunction with an exercise test on a treadmill or bicycle, during which an EKG and multiple blood pressures are taken. While you are exercising you will be given a small injection of a radioactive compound that will be absorbed by your heart muscle. After the exercise portion of the test, multiple images of your heart will be taken to evaluate the distribution of blood flow to your heart during exercise. It will take about 30 minutes to acquire these images.
3. Bone Scan
Bone scans are used to detect diseases of the bone at the earliest possible time. Bone scans are often more sensitive than X-rays in diagnosing infections, tumors, and fractures.

You will receive an injection of a radioactive substance in a vein in your arm. This material travels through the bloodstream, into the soft tissue, eventually localizing in the bones. You will not feel anything from this injection. We may take some images during the injection to evaluate the blood flow to a particular area where you may be having pain.

The bone scan itself will be done about 2 hours after injection. The scan will take 30-60 minutes. You will lie on your back on an imaging table. The camera will be positioned above you and below you. The camera may scan the entire length of your body, starting at your head and moving slowly to your feet.
4. Thyroid Scan
A thyroid uptake measures overall thyroid gland function. A thyroid scan shows the structure, size and location of your thyroid and the function of various portions of your gland. This procedure involves two visits to the Radiology Department.

On the first day, you will be asked to swallow a small amount of radioactive iodine in a capsule. This visit should take about fifteen (15) minutes. About 4 to 6 hours later you will return for the first measurement of uptake and the scan, which will take about fifteen minutes. The next day, you will return for the remainder of the uptake procedures, which will take 15 to 30 minutes.

For the scan, you will lie on your back on an imaging table with the camera positioned above you. We will take several images of your thyroid. Each image takes five or ten minutes. We may take additional images to look at a certain part of your gland in detail. The imaging procedure will take about 45 minutes.

The uptake procedure measures the absorption of the radioactive iodine by your thyroid gland.
5. Lymph Node Mapping
Many Tumors metastasize, or travel, through lymphatic channels. Defining the anatomy pattern of nodes that drain form a tumor is the function of this test.

For this procedure, a radioactive isotope is injected around the melanoma, or cancer, and images are taken to determine the “hot” sentinel lymph nodes to which the isotope has spread. Once the imaging has been completed, the patient then will go to surgery to isolate and remove the lymph node.

Stereotactic Breast Biopsy

Once a lump or abnormality has been detected, your doctor may want to conduct a biopsy. This procedure involves taking sample tissue from the suspicious area to determine whether it is cancerous. While the thought of having a biopsy might be frightening, the results can provide reassuring peace of mind. Remember, the vast majority of biopsies turn out to be non-cancerous. And a biopsy is currently the only way to achieve an accurate diagnosis.

This procedure is used to find out whether the lump on your breast found by your physician is cancerous or not. Stereotactic Breast Biopsy is a non-surgical procedure completed on an outpatient basis with a minimum of discomfort and recovery time.

Upon entering the procedure area, the woman lies facedown on a special table. The table has a hole through which the breast is placed. The breast is slightly compressed to immobilize it, just as in a mammogram. This allows our radiologist to get a clear mammographic image of the area to be sampled. The table is connected to a computer that processes digital images. Placement of the sampling device is guided by a computerized system using x-rays.

Two images at different angles are taken that allow the computer to localize the mass and calculate the coordinates. Local anesthesia is used before the vacuum - operated needle is advanced to the coordinates that were calculated by the computer. The advance of the needle is followed by several images.

Once the needle is seen to be in the breast mass or the breast microcalcification, vacuum-assisted biopsies are taken. The patient is awake throughout the whole procedure and can go home with a Band-Aid shortly thereafter. The pathology specimens are sent to a pathologist, and the results are usually known within two to four days.

Ultrasound

Ultrasound imaging is excellent for non-invasively imaging and diagnosing a number of organs and conditions, without x-ray radiation. It uses very high frequency sound waves to produce an image of the internal structures of the body. Unlike x-rays, that use radiation to produce images, ultrasound uses sound wave, which are harmless, even on pregnant women.

A transducer (a small microphone like device) is placed over the area being examined. Sound waves pass through the skin from the transducer. The sound waves bounce off certain organs and tissues in the body. This creates “echos”. The echoes are reflected back through the transducer and onto a television monitor. Ultrasound is a useful tool that can help, detect or monitor:

Heart
Pelvis and reproductive organs
Kidneys, liver, pancreas, gallbladder
Thyroid
Blood vessels
Fetus - 3D/4D imaging available at CRMC

X-ray

X-rays help identify disease or injury to different areas of the body. During an x-ray, a small, carefully calculated amount of radiation is directed toward a specific part of the body to produce an image. The entire process is fast and painless. Images created by x-rays show different features of the body in various shades of gray, similar to a photograph negative. The gray is darkest in those areas that do no absorb x-rays well. The grays are lighter in dense areas, such as bones, that absorb more of the x-rays.