» How much radiation do I get from an MRI exam?
None. An MRI exam uses magnets to measure the small magnetic changes in your own body to generate detailed images. Magnetic resonance imaging does not rely on ionizing radiation.
» How long is the MRI exam?
Most studies take 20-45 minutes. Depending on what part of the body is studied, it may take as long as two hours. When you schedule your appointment, the schedulers and technologists will be happy to explain your anticipated procedure time in more detail.
» What if I am claustrophobic and get uncomfortable in small spaces?
Some people do get claustrophobic and are uncomfortable in the MRI machine. If you think this will happen to you, please talk about it with your doctor. He or she may give you an oral medication to take 30 minutes before the study to minimize the claustrophobic feelings that some individuals experience during an MRI examination. Usually this is all you need to overcome a claustrophobic reaction during the examination.
» I have heard that an “Open MRI” is less claustrophobic. May I have it?
Several of our MRI machines have large openings which result in a more comfortable exam, and less claustrophobia. If you do have claustrophobia or are uncomfortable fitting in a traditional closed MRI, an alternative is a new type of open MRI available now at Open MRI of the Rockies. This new high-strength open MRI will provide high quality images in a more comfortable, open environment.
» I have too much pain to lie still. How can I have my MRI?
Specially trained radiologists and technologists will work with you to ensure that you have a comfortable, pain-free test. Sometimes this is as simple as helping you find a comfortable position while you lie down for the test. Depending on your condition, you may receive a shot, an IV medicine, or complete anesthesia. Our goal is for you to have your test as quickly and comfortably as possible.
» When will my doctor get the test results?
Our radiologists interpret all of your pictures and compare your current study with any previous radiology examinations. Our typed report is available to your doctor usually within one day.
» What should I expect during the procedure?
While the unit is scanning the images, the CT gantry rotates in a circle to allow the x-ray tube to image from all angles. There is whirring and clicking in the CT unit while the tube is rotating for the pictures. The table will slowly slide through the ring to allow the machine to cover the necessary segment of the body. If iodinated IV contrast is used, this may cause a warm flushing feeling through the body and occasionally a metallic taste in the mouth, both of which are experienced only momentarily.
» How long will my CT exam take?
The CT scan itself usually takes 10 to 15 minutes. If you receive IV contrast, it may take slightly longer.
» How much radiation do I get from a CT scan?
New CT scanning machines are designed to expose to radiation only the small part of your body that is being examined. The amount of radiation you receive is comparable to the same amount you get for plain x-rays of the abdomen or spine, depending on what areas are to be imaged. One of our goals is to perform each CT scan with as little radiation as possible while still obtaining the images needed to make a diagnosis.
» What if I am pregnant?
If so, we do not recommend this test since there is exposure to radiation. If you are not sure, but think you may be pregnant, be sure to inform the technologist of this possibility before proceeding.
» How do I prepare for a CT scan?
As noted above, your examination may or may not require any pre-procedure preparation.
If you have a known allergy to iodine or iodinated IV contrast (dye), please call the facility where your examination is scheduled, and ask to speak with one of the radiology nurses at least one day before your CT scan. For CT studies, in which you will receive either IV or oral contrast, please do not eat or drink anything except for the oral liquid contrast for 3 hours prior to the study.
» I am allergic to X-ray dye. What do I do?
If your CT study requires iodinated intravenous (IV) contrast (dye), you should speak with a radiology nurse the day before the study. Usually the study can be safely done with contrast even if you have an iodine-allergy history. Generally, we recommend treating you the night before and the morning of your study with several medications designed to decrease your chance of an allergic reaction. These medicines often include common histamine-blockers like Benadryl and Tagamet, and potent anti-inflammatory steroid medications. While allergic reactions to IV contrast can occur, trained physicians and nurses with necessary medications and equipment are always available to treat any reaction.
» When will my doctor get the test results?
Our radiologists look at all of you CT images and compare the study with any previous exams you may have had. Our typed report is available to your doctor usually within one day.
» I have kidney disease or poorly functioning kidneys. Does this matter?
If so, we recommend that your doctor obtain a blood test to show the status of your kidney function before you have the CT exam if it is anticipated that you will require iodinated IV contrast.
» I have diabetes. Does this matter?
If so, we recommend that your doctor obtain a blood test to show the status of your kidney function before you have the CT exam. If you take Glucophage or Glucovance for Type II diabetes, and we administer iodinated IV contrast for the exam, we will ask you to withhold your medication for 48 hours after the exam. You may resume your medication after your doctor checks a blood test to show that your kidneys function has not changed.
» How much radiation do I get from an x-ray?
It depends on what part of the body is examined. For chest x-rays, the amount of radiation a patient receives is very tiny—only a fraction of the amount of radiation a person gets while walking around in the sunshine over a year. Although still quite small, the dosage may be larger for other types of x-rays. For this reason, you only want to have x-rays if you really need them.
» How do I prepare for a standard x-ray?
No patient preparation is needed.
» When will my doctor get the test results?
Our radiologists interpret all of your pictures and compare your study with any of your previous examinations. Our typed report is available to your doctor usually within one day.
» How do I prepare for an Upper GI, swallowing study or IVP? Recommend reaching out to the facility it will be performed at for prep.
Please do not eat or drink anything on the morning of the examination. Even drinking a small amount of fluid on the morning of the examination is enough to prohibit adequate barium coating of your stomach, making the study of poor quality.
» How much radiation do I get from an Ultrasound?
Ultrasound uses sound waves and, hence, no radiation is involved.
» How do I prepare for my Ultrasound exam?
- Neck/Thyroid Ultrasound
Please wear loose fitting clothes, especially a shirt or blouse with a loose-fitting collar. Necklaces and other such jewelry, which may limit access to the neck, should not be worn.
- Gallbladder Or Abdomen Ultrasound
Please do not eat or drink anything for 6 hours before the study. This helps the gallbladder fill with fluid and makes it easier to see.
- Pelvis Ultrasound
There is no special preparation. Previously, patients were asked to drink a large amount of water before the study, to make your bladder full; this is no longer necessary.
- Pregnancy Ultrasound
Again, no special preparation is needed.
» How does a nuclear medicine study actually work?
Usually, tiny amounts of radioactive material are injected into the patient’s vein through a standard IV. Pictures are then taken with a Gamma camera (essentially a sophisticated Geiger counter) that measures how much radioactivity the area being examined is registering, ultimately generating images that reflect important functional anatomy.
» Is the radioactivity dangerous?
The amount of radiation the body is exposed to is very small. It is actually smaller than many types of regular x-rays.
» How do I prepare for my nuclear medicine study?
- Gallbladder Nuclear Medicine Study (A HIDA Scan)
Please do not eat or drink anything for 6 hours before the study.
- Other Nuclear Medicine Studies
If special preparation is necessary, we will explain it to you when you schedule your examination.
» When will my doctor get the test results?
Our radiologists look at all of your pictures and compare this study with any previous examinations you may have had. Our typed report is available to your doctor usually within one day.
DEXA Bone Densitometry
» What are some common uses of the procedure?
DEXA bone densitometry is used most often to diagnose osteoporosis, a condition that often affects women after menopause, but may also be found in men. Osteoporosis involves a gradual loss of calcium, causing the bones to become thinner, more fragile, and more likely to break. The DEXA test can also assess your risk for developing fractures. If your bone density is found to be low, you and your physician can work together on a treatment plan to help prevent fractures before they occur. DEXA is also effective in tracking the effects of treatment for osteoporosis or for other conditions that cause bone loss.
» What are the benefits of a bone densitometry scan?
Bone densitometry is a non-invasive, accurate, inexpensive way of detecting osteoporosis. The procedure takes 15 – 30 minutes and does not require undressing. A bone densitometry scan:
- Can be beneficial for any age or gender
- Provides early detection that some other tests may miss
- Can measure multiple sites of the body to determine the most appropriate treatments
- Can estimate fracture risk
- Is easily administered with a low radiation dose that is roughly equivalent to a cross-country airline flight
» When should I start getting mammograms and how often should I get them?
Although various medical organizations disagree on when to begin screening mammography and at what intervals, all agree that screening mammography is beneficial, and that women who have screening mammograms die of breast cancer less frequently than those that do not have mammograms. Current screening data shows that yearly screening beginning at age 40 saves 71% more lives than screening every two years and beginning at age 50, as recommended by the United States Preventive Services Task Force (USPSTF) in 2009.
The following organizations recommend annual mammography screening beginning at age 40 for average risk women:
- American College of Radiology (ACR)
- American Congress of Obstetricians and Gynecologists (ACOG)
- National Cancer Consortium Network (NCCN)
- Society of Breast Imaging (SBI)
The following organizations recommend the decision to start screening should be an individual one. Women who place a higher value on the potential benefit and the potential harms may choose to begin screening at the following ages:
- American Academy of Family Physicians (AAFP): Ages 40-49, then every other year at and after age 50.
- United States Preventive Services Task Force (USPSTF): Ages 40-49, then every other year at and after age 50.
- American Cancer Society (ACS): Ages 40-44, then yearly from age 45-54, then every other year after age 55.
- American College of Surgeons: Ages 40-44, then yearly from age 45-54, then every other year after age 55.
» Should I do breast self-examinations?
Terminology for self-exam is evolving, and may now be referred to as “breast awareness”. A minority of breast cancers continue to be detected as a palpable lump rather than by mammography. Breast cancers may also present with breast changes of skin redness, pain, itching, or a bloody or clear nipple discharge. The USPSTF and AAFP recommend that providers should not teach breast self-exam. In contrast, the ACS and NCCN encourage breast awareness, stating that women should be familiar with how their breasts normally look and feel, and report any changes to a health care provider right away. OCOG and NCCN recommend an annual clinical breast exam after age 40, and NCCN recommends a clinical breast exam from 25-39 years of age every 1-3 years.
» What are the risk factors for breast cancer?
Please refer to Cancer.org for more details on the following:
» What is breast density and why does it matter on my mammogram?
In 2017 Colorado enacted a breast density notification law that requires that each patient that receives a mammogram be notified of their breast density. AMIC radiologists include this information on each mammography report, and in a letter mailed to the patient with her mammography results and breast density.
There are four categories of normal breast density:
- Almost entirely fat – breasts are almost entirely composed of fat. 1 in 10 women
- Scattered fibroglandular densities – scattered areas of dense tissue, but the majority of the breast is not dense, 4 in 10 women have this result.
- Heterogeneously dense – there are some areas of non-dense tissue, but the majority of the breast tissue is dense, 4 in 10 women have this result.
- Extremely dense – nearly all of the breast tissue is dense, 1 in 10 women.
Having heterogeneously dense or extremely dense breasts increases your risk for breast cancer. It also increases the likelihood that breast cancer may go undetected by a mammogram, since the dense breast tissue can mask a potential cancer. Despite concerns about detecting cancer in dense breasts, mammograms are still effective.
» I have been told I have dense breasts, does this change anything for me in terms of screening?
If you have been informed that you have dense breast tissue, then you should strongly consider supplemental screening for breast cancer using breast 3D tomosynthesis.
» Would you summarize the message that I should take home to my mother, sisters, daughters, and friends about breast cancer screening?
Breast cancer screening recommendations as a whole are unfortunately complicated and without a unified message amongst health professional organizations. This has occurred because it is a complicated topic, and because a public health researcher views breast cancer screenings from a different perspective than a breast oncologist, a breast radiologist, a cancer society, or a family physician. If all perspectives were compiled together, then a recommendation might be:
If you desire to reduce the chance that you will die of breast cancer, and you accept that this may involve some anxiety and stress, then having a screening mammogram every year beginning at age 40 is your best choice. No other method of screening the breast, interval of screening, or age to start screening has better overall effectiveness.
» What is the BRCA gene and how do I know if I have this gene?
About 5-10% of breast cancers are hereditary, meaning that they are passed on from a parent with a gene defect. The most common hereditary breast cancer is the mutation in the BRCA1 or BRCA2 gene. A woman with the BRCA1 or BRCA2 gene mutation has about a 7 in 10 chance of getting breast cancer by age 80. There are other gene mutations that can lead to inherited breast cancer. Genetic testing may be indicated for patients with an appropriate family history of cancer, but consultation with a genetics counselor or health provider is recommended first to weigh the pros and cons.
» Does radiation exposure from annual mammograms increase my risk of thyroid cancer? Should I request a thyroid shield?
The amount of radiation women receive from annual mammograms does not increase their likelihood of developing thyroid cancer (ACR and SBI). A thyroid shield is unnecessary.
» If I am high risk for breast cancer, does that change the recommendations for breast cancer screenings?
To receive a free online estimate of your breast cancer lifetime risk, go to: https://bcrisktool.cancer.gov, or discuss other methods for determining your lifetime risk number with your health care provider. If you have a greater than 20% lifetime risk for breast cancer then the American Cancer Society recommends that you have an annual screening MRI in addition to a screening mammogram. Yearly mammograms and breast MRI begin earlier than 40 years of age in some patients who are at high risk for breast cancer. All high risk patients should consider counseling in a breast cancer high risk clinic to define the appropriate breast cancer screening algorithm.
3D Mammography (Tomosynthesis)
» What is 3D breast tomosynthesis and how is it different than 2D?
Breast tomosynthesis creates not just one image of the breast (2D mammogram), but also a stack of thin image “slices” of the breast (3D mammogram). The breast is evaluated by the radiologist using both 2D and thin slice-by-slice(3D). The 3D imaging minimizes the masking effect of overlying tissue and this improves cancer detection. The reduced masking effect also helps the radiologist reduce the number of patient call-backs to the breast center for evaluation of overlapping breast tissue.
» What is breast MRI and can it replace my mammography screening?
MRI images the breast in a completely different way than mammography. It does not use x-rays, but magnetism and radio frequency waves to generate detailed images of the breast. A breast MRI is useful as a problem-solving imaging tool and for supplemental screening of patients at high risk for breast cancer, but not as a replacement for screening mammography. MRI is very sensitive for the detection of breast cancer masses, but it also identifies findings that look like cancer, but are not. This may lead to unnecessary additional breast imaging and biopsies. Breast MRI is a more time consuming and costly breast imaging method than mammography. Breast MRI is not sensitive for detecting breast cancers that present as microcalcifications that are only seen well by mammography.