Womens Imaging
Breast Imaging
Diagnostic and screening examinations of the breast for various conditions and diseases such as cancer include an array of both conventional and newer imaging technologies, all designed to provide a high level of information in a minimally invasive manner. The goal of these procedures is to gather the information necessary to make an accurate diagnosis. The procedures that follow are performed by a board certified radiologist or interventional radiologist and, where appropriate, a certified ultrasonographer.
Mammography
Mammography is a specialized x-ray imaging examination that uses x-rays to produce an image on film. More recently, mammography is now performed using digital imaging technology that has in many cases eliminated the need for traditional x-ray film. In mammography, the breast is positioned over a digital receptor and is slightly compressed. The x-ray or mammogram is taken and is digitally sent to a reading room to be read by the radiologist. Typically mammography is used to:
- Clarify questions arising from a screening mammogram
- Identify the causes of breast related symptoms such as a lump, pain or discharge
- Aid in a diagnosis where there may be a history of breast cancer
Breast Ultrasound
Breast ultrasound is very helpful in distinguishing between cysts and solid masses. In a breast ultrasound examination sound waves are used to generate an image of the breast tissue. Typically a handheld transducer is placed on the breast and sound waves emitting from the transducer are bounced back from the breast’s internal structures and received by the transducer. The reflections or echoes are then converted electronically to produce a constantly changing image on a video screen. Usually, a radiologist will make a diagnosis from the images however, depending on the findings, a needle biopsy may be performed to confirm any suspected indications.
MRI of the Breast
MRI of the breast (Magnetic Resonance Imaging) is a medical imaging procedure that uses a strong magnetic field, radio frequency waves and computers to acquire images with exceptional anatomic detail. There is no x-ray involved. Computer analysis of the data allows the radiologist to view detailed images in multiple planes or slices. This procedure is frequently used with patients having a known breast cancer to determine the extensiveness of the disease. Typically a patient lies face-down within the scanning field for approximately 25 minutes and the digital images that result are interpreted by the radiologist and a diagnosis is made.
PEM
Positron Emission Mammography (PEM) produces high resolution images designed to help physicians treat breast cancer more effectively. PEM is highly advanced imaging technology that provides valuable information for women at risk for, or diagnosed with breast cancer. It is a device that is optimized for the breast, producing very sharp, detailed images of abnormal tissue.
Breast Biopsy
Breast biopsies are usually done on an outpatient basis by a specially trained radiologist and generally take 45 minutes to one hour.
Stereotactic-Guided Breast Biopsy
In his procedure,the patient lies facedown on a specially designed table with one breast positioned through a hole in the table. Two digital x-ray images are taken from different angles, allowing the radiologist to precisely localize the area for biopsy. Once the area has been located, the radiologist numbs the area with a local anesthetic and then uses computer guidance for precise needle placement and collection of small tissue samples. The resulting samples are then sent to a laboratory for analysis.
Ultrasound-Guided Breast Biopsy
This is a specialized ultrasound procedure that is used to direct the needle in collecting breast tissue samples. The sound waves picked up by the handheld transducer produce images on a video screen that help guide the placement of the needle in the correct location where samples are to be collected. The resulting samples are then sent to a laboratory for analysis.
MRI-Guided Breast Biopsy
In this exam, the patient lies facedown on an exam table with one breast positioned through a hole in the table. Prior to the start of the actual MRI procedure, a technologist will insert an IV into a vein to administer contrast material. The breast is gently compressed between two plates one of which has a grid on it and using computer software, an interventional radiologist will then calculate the position of a suspected lesion and needle placement on the resulting images. Once the area has been located, the radiologist numbs the area on the breast with a local anesthetic and inserts the needle for sample collection. The positioning of the needle is then verified by another set of images. The resulting samples are then sent to a laboratory for analysis.
Ductography
A ductogram is generally performed when there is persistent nipple discharge and an ensuing mammogram is normal. A tiny tube is inserted into the duct and a small amount of contrast dye is injected into it. Several conventional or digital mammograms are then obtained in which the images produced will show the ducts outlined by the contrast. The images are then used by a radiologist to identify whether or not there is a condition present that is producing the discharge.
