Many people call to ask exactly "What is a PET scan?" Positron Emission Tomography is a relatively new modality to the medical scene. It was introduced in 1974 but was still considered "experimental" in 2001. Today, however it has advanced to a highly diagnostic tool for physicians to use for diagnosis and treatment. The procedure is performed in the Nuclear Medicine Dept..(most often) where a radioactive isotope is injected into the bloodstream. This material is tagged, or mixed, with another agent to enable it to enhance a particular organ. After the injection the patient is placed
on a table, most often on their back, and moved into a machine. This machine is open on the sides so it isn't as constraining as the MRI machine. The machine scans the patient and sends information to a computer where it is processed and sent to the Radiologist for interpretation.
PET scanning has become a vital tool in the treatment of cancer patients. It can provide the Oncologist and Radiologist detailed information regarding the stages of cancer as well as the effectiveness of chemotherapy and radiation therepy treatments.Many times it is performed along with a CT exam. CAT scans can provide excellent detail of the anatomy in a 3-D representation. PET scans don't show the anatomy as well, but can provide great information regarding the functioning of the organs demonstrated.
Tuesday, November 27, 2007
Saturday, November 24, 2007
More Questions/ X-Ray Information
Living in a small town is sometimes a bad thing. Everyone knows you..AND knows where you work. I have people calling me quite often to ask about their x-ray reports, the preparations, who's in the hospital, you name it. But, here are a few of the more popular questions I am asked.
When will MY doctor get the report? Truthfully, that's a very complex question. Most all x-rays performed before 5:00 pm will be read that same day(at my hospital anyway) The reports are transcribed & sent to the ordering physician..that day. Some places have the orders faxed over to the physician. At our hospital the Dr's office has to come over to pick up reports. And therein lies part of the problem. IF the office is very busy they may not have time to come and pick up reports..that day. Invariably, the patient calls us to say that the x-rays were not read and so they just don't have results yet. In most hospitals the x-rays are read the same day or the day after so you should definitley have results within 2 days.
Why do I have to remove jewelery when having an x-ray? This is an easy one. X-ray will pass through clothing but it cannot penetrate metallic objects. These objects will be white blobs on the x-ray film and can possibly cover up some pathology. We also have patients remove zippers, buttons, etc. for the same reason. It is advisable to wear clothing suitable, such as sweat pants, or elastic waist pants. Shirts with no buttons, and for women a sports bra, as it has no metal.
Will an x-ray show a torn cartilege? Simply put, an x-ray primarily shows bones. Granted, the Radiologist can tell alot, but typically to see a torn cartilege, usually in the knee, the patient needs to have an MRI. MRI shows exquisite detail of the tissues and ligaments, whereas x-ray cannot.This is also very helpful for patients that may have a rotator cuff problem.
Why do I have to hold my breath for x-rays? It really depends on which type of x-ray you are having. Basically, when a person breathes the diaphragm moves up and down. If I am x-raying the kidneys and my patient breathes, the kidneys look blurred because they do in fact move when the patient breathes. If I am x-raying a patient's chest to see the lungs,heart, etc..I need the patient to take a really deep breath and hold it in. The reason is that on deep inspiration the lungs are completely filled with air, and I can also see more of the heart shadow.
These are just a few of many questions. Post me if you have any you would like answered.
When will MY doctor get the report? Truthfully, that's a very complex question. Most all x-rays performed before 5:00 pm will be read that same day(at my hospital anyway) The reports are transcribed & sent to the ordering physician..that day. Some places have the orders faxed over to the physician. At our hospital the Dr's office has to come over to pick up reports. And therein lies part of the problem. IF the office is very busy they may not have time to come and pick up reports..that day. Invariably, the patient calls us to say that the x-rays were not read and so they just don't have results yet. In most hospitals the x-rays are read the same day or the day after so you should definitley have results within 2 days.
Why do I have to remove jewelery when having an x-ray? This is an easy one. X-ray will pass through clothing but it cannot penetrate metallic objects. These objects will be white blobs on the x-ray film and can possibly cover up some pathology. We also have patients remove zippers, buttons, etc. for the same reason. It is advisable to wear clothing suitable, such as sweat pants, or elastic waist pants. Shirts with no buttons, and for women a sports bra, as it has no metal.
Will an x-ray show a torn cartilege? Simply put, an x-ray primarily shows bones. Granted, the Radiologist can tell alot, but typically to see a torn cartilege, usually in the knee, the patient needs to have an MRI. MRI shows exquisite detail of the tissues and ligaments, whereas x-ray cannot.This is also very helpful for patients that may have a rotator cuff problem.
Why do I have to hold my breath for x-rays? It really depends on which type of x-ray you are having. Basically, when a person breathes the diaphragm moves up and down. If I am x-raying the kidneys and my patient breathes, the kidneys look blurred because they do in fact move when the patient breathes. If I am x-raying a patient's chest to see the lungs,heart, etc..I need the patient to take a really deep breath and hold it in. The reason is that on deep inspiration the lungs are completely filled with air, and I can also see more of the heart shadow.
These are just a few of many questions. Post me if you have any you would like answered.
Saturday, November 17, 2007
What About Contrast-X-ray Information
There is definitley a big buzz right now concerning contrast and X-ray Information.Television ads with Legal advice concerning anyone who has had MRI contrast. What's it all about and why is it so popular right now? That's a pretty good question. I have been an x-ray technologist for 35 years and have used IV Contrast materials..of one form or another, from the very beginning. Years ago the IV (meaning Intravenous..or through a vein) used to contain almost 60% iodine. The good thing was that this worked well for the x-rays..it helped everything to show up well. The bad part was that alot of patients either became very nauseated during the exam, or some developed hives,etc.. Not everyone had problems, but quite a few did. This was the "best" that we had at the time and the standard contrast agent to use. Keep in mind that Contrast agents are very necessary for some x-ray tests because Organs within the body are hollow and will not show up. The Contrast media fills the organ and it is demonstrated on the x-ray. As mentioned on a previous blog post..there are 2 types of Contrast. One is the Oral type that you drink and it rarely causes any problems other than occasional diarrhea. The IV contrast goes into the bloodstream and can present a problem for some patients.
It is required by every Hospital X-ray Dept. that a patient fill out a history sheet and present a list of medications they are currently taking. Most patients view this as a chore, un-necessary paperwork, or whatever. It could not be further from the truth. Each question on the history sheet is vitally important to the technologist performing your exam and to the Radiologist who is reading it. First question is "Have you ever had IV contrast material before?"...This is very important because IF you have had it previously, and IF you had ANY type of problem with it, the Radiologist will probably tell you that you CANNOT have the x-ray contrast ever again. WHY you ask? IF you had a few hives the first time, your body is telling you something is wrong and not to do it again. We take that seriously and know that the next time it could be much worse and possibly fatal. I usually tell my patients that have had a prior reaction to Contrast that they should consider obtaining a Medic ALert bracelet, or necklace. IF perhaps you were in a serious accident you may not be able to inform medical personnell that you are allergic to the contrast. They might send you directly for a CAT scan with IV contrast, and that could have some serious consequences. So, I think that's important. We also require patients to have current blood work for BUN & Creatinine..This tells us how the kidneys are functioning. Patients who are over 70 or diabetic are at risk for problems here. We cannot..or will not..administer the contrast without a recent BUN/creatinine. IF you fail to give correct history to the technologist you can cause serious problems for yourself. Many times these problems with Contrast are caused by improper information from the patient themselves. Always carry a current list of medications you are taking so we can be sure the contrast will not conflict with them. Try to pay very close attention to x-ray information,either written or oral, so you can work with the technologist to provide the best and safest exam possible. IF you have any questions always call ahead and ask the X-ray technologist. Most hospitals staff 24 hours every day and they are more than happy to explain anything you need. It's our goal to provide you with the most accurate information so you can assist us with your care. I hope this x-ray information has helped you to better understand Contrast and x-rays.
It is required by every Hospital X-ray Dept. that a patient fill out a history sheet and present a list of medications they are currently taking. Most patients view this as a chore, un-necessary paperwork, or whatever. It could not be further from the truth. Each question on the history sheet is vitally important to the technologist performing your exam and to the Radiologist who is reading it. First question is "Have you ever had IV contrast material before?"...This is very important because IF you have had it previously, and IF you had ANY type of problem with it, the Radiologist will probably tell you that you CANNOT have the x-ray contrast ever again. WHY you ask? IF you had a few hives the first time, your body is telling you something is wrong and not to do it again. We take that seriously and know that the next time it could be much worse and possibly fatal. I usually tell my patients that have had a prior reaction to Contrast that they should consider obtaining a Medic ALert bracelet, or necklace. IF perhaps you were in a serious accident you may not be able to inform medical personnell that you are allergic to the contrast. They might send you directly for a CAT scan with IV contrast, and that could have some serious consequences. So, I think that's important. We also require patients to have current blood work for BUN & Creatinine..This tells us how the kidneys are functioning. Patients who are over 70 or diabetic are at risk for problems here. We cannot..or will not..administer the contrast without a recent BUN/creatinine. IF you fail to give correct history to the technologist you can cause serious problems for yourself. Many times these problems with Contrast are caused by improper information from the patient themselves. Always carry a current list of medications you are taking so we can be sure the contrast will not conflict with them. Try to pay very close attention to x-ray information,either written or oral, so you can work with the technologist to provide the best and safest exam possible. IF you have any questions always call ahead and ask the X-ray technologist. Most hospitals staff 24 hours every day and they are more than happy to explain anything you need. It's our goal to provide you with the most accurate information so you can assist us with your care. I hope this x-ray information has helped you to better understand Contrast and x-rays.
Tuesday, November 13, 2007
Pediatric X-Ray Information
CT, or Cat Scans, are a very important tool for physicians to use when diagnosing children. This is however, a two edged sword. Children are at a greater risk because they a longer life span to get a radiation related cancer. Fortunatley, there are ways to reduce radiation to children when they are sent for examinations. The National Cancer Institute recommend several steps for reducing radiation dosage to patients.
The First Step: Only Ct examinations that are very necessary should be performed. Pediatricians and Radiologists should speak together regarding the use of CT as opposed to other modalities that would not require radiation.
The Second Step: IF CT is the preferred route, then exposure settings should be adjusted accordingly so as to optimize the study and Minimize radiation exposure. This can be done by: a) Limit the area to be scanned to the smallest possible area.
b) Adjust the MA settings for the organ area to be scanned, ie..lower MA settings for bone and lung fields.
c) Adjust the technique for the child's size and weight.
d)Determine the correct scan resolution( lower resolution may be ok for some diagnostic purposed )
Physicians should be extremely vigilant when ordering CT examinations for children. They should refrain from ordering multiple scans for contrast enhancement.
Speaking with the Radiologist or the CT Technologist can help to minimize unnecessary exams and radiation dosage.
A recent study found that from 1991 to 2002 there had been a 4 fold increase in the number of CT examinations ordered. It also found that the cumulative dose per patient had doubled during that time frame. While this should not be alarming to us, it should definitley be an alert. It is too easy to go to the physician stating such and such a problem & that you want a Cat Scan for it. Most physicians go along with the patient a good percentage of the time because patients will just go somewhere else to get it done. The important thing to remember is that the physician is trained, highly trained, to diagnose and treat his patients. There are many ways to diagnose problems, and CT is but one of those methods. Point being, IF your Dr. wants to start out with blood work, or an Ultrasound exam, then go with that. Anytime you can find the cause with an invasive test or without radiation exposure, by all means, Go for it! This is true with adults and even more so with children.
This information was taken from an ASRT article/ October 2007/Patient Dose From CT
The First Step: Only Ct examinations that are very necessary should be performed. Pediatricians and Radiologists should speak together regarding the use of CT as opposed to other modalities that would not require radiation.
The Second Step: IF CT is the preferred route, then exposure settings should be adjusted accordingly so as to optimize the study and Minimize radiation exposure. This can be done by: a) Limit the area to be scanned to the smallest possible area.
b) Adjust the MA settings for the organ area to be scanned, ie..lower MA settings for bone and lung fields.
c) Adjust the technique for the child's size and weight.
d)Determine the correct scan resolution( lower resolution may be ok for some diagnostic purposed )
Physicians should be extremely vigilant when ordering CT examinations for children. They should refrain from ordering multiple scans for contrast enhancement.
Speaking with the Radiologist or the CT Technologist can help to minimize unnecessary exams and radiation dosage.
A recent study found that from 1991 to 2002 there had been a 4 fold increase in the number of CT examinations ordered. It also found that the cumulative dose per patient had doubled during that time frame. While this should not be alarming to us, it should definitley be an alert. It is too easy to go to the physician stating such and such a problem & that you want a Cat Scan for it. Most physicians go along with the patient a good percentage of the time because patients will just go somewhere else to get it done. The important thing to remember is that the physician is trained, highly trained, to diagnose and treat his patients. There are many ways to diagnose problems, and CT is but one of those methods. Point being, IF your Dr. wants to start out with blood work, or an Ultrasound exam, then go with that. Anytime you can find the cause with an invasive test or without radiation exposure, by all means, Go for it! This is true with adults and even more so with children.
This information was taken from an ASRT article/ October 2007/Patient Dose From CT
Sunday, November 4, 2007
X-ray and Kids
I have been an x-ray tech for almost 32 years...if you count my two years of training. To say that I have a soft spot for kids and old people would be an understatement. It's hard to describe really, but there's just something precious about them, all of them, that makes my day. Most kids, even though they are scared, will do better with injuries than adults. Seriously, I have gone over to the Emergency Room to x-ray a child with a broken arm. It may be broken and severely displaced..(meaning not straight at all)..The child will be laying there trying to be very still and very quiet. Some will be screaming but most will not. Adults on the other hand, with the slightest sign of trauma they are screaming for pain medicine. Hard to believe..but it is very true. Kids are much tougher than we are! Old people, I mean from 75-95, they do great too. Most do not complain. A little lady I x-rayed the other night was 88. Cute as a button too. She had fallen and it appeared that her hip was probably broken. I explained to her what we had to do. She just smiled and said "Honey, do what you have to do"..She never yelled, just the opposite...she did her best to help me the entire time. I have a great respect for the older generation. They have been through so much in their lifetime and they handle it all with such grace. They have alot to teach us and I think that children do as well. INstead of US trying to teach them, perhaps we should stop and actually look at how they handle things. I really think we could learn alot.
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