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A Sharper Image

by Eileen Glanton Loftus

Advancements in radiology have led to faster diagnoses—and less anxiety—for patients.

Radiology is a vast specialty that encompasses everything from X-rays that detect broken bones to long-term therapy for cancer. Driven by technology, the field is constantly changing, and can be daunting to a patient facing a radiological procedure for the first time.

Most hospitals have their own radiology divisions, but many procedures are performed at offices specializing in the practice. South Jersey is home to several radiology practices that offer a wide range of imaging services. Recent developments in technology have made the experience more patient-friendly and more effective in detecting illness and injury.

The best test for you
First, a primer on some of the main types of radiologic tests:

X-rays are a form of radiation that can be focused into a beam and can pass through the human body. When they are exposed to film, they produce a visual image of the inside of the body. They are commonly used to detect and observe bone fractures.

Ultrasounds use sound waves to produce images of internal organs like the liver, gallbladder or the uterus. A technician applies gel or oil to the skin, then runs a wand-like tool called a transducer over the area that’s being examined. Sound waves quickly produce an image that may be displayed on a TV screen and printed out for the patient.

CT stands for computed tomography, and it can be used to study any part of the body: internal organs, including lungs and heart, blood vessels and bones. In these tests, a CT scanner sends X-ray pulses through the body. Each short pulse takes a picture of a thin slice of the area being studied. An iodine dye may be used to make the area easier to see.

MRI, or magnetic resonance imaging, combines radio waves and magnetic field procedures to produce very clear images of the body, including the brain, bones or internal organs like the kidney and the liver. The tests do not involve radiation and can therefore prevent the patient from any negative side effects of radiation. Images are stored digitally, which makes for easy communication between different doctors’ offices, and makes it possible to view images from remote locations, such as operating rooms. Patients are generally referred to a radiologist by another doctor, whether it be their general practitioner or a specialist. For example, an oncologist will rely on regular CT scans or MRIs to monitor a cancer patient’s lesions and their response to treatment.

In general, a technician performs radiological procedures, then the images are interpreted by a doctor who specializes in radiology. Dr. Markus Whitley, president of Booth Radiology, with three sites in South Jersey, says after completing medical school, some doctors continue on for lengthy residencies in radiology after which many also choose subspecialties, such as breast imaging or musculoskeletal MRI. All of the radiologists at Booth Radiology are subspecialty trained.

“It’s important to get your images done on the machine that provides the highest quality technical information, but it’s also important to have the images evaluated by a doctor that is adept at using that machine,” Whitley says. “Each technological advance requires radiologists to become familiar with the nuances of that subspecialty.”

Physicians have varying standards on how they relate the radiologist’s findings to the patient.

“The results can be discussed by me or by the referring doctor,” says Dr. William Muhr, president of South Jersey Radiology Associates (SJRA). “Most of the time, it’s the referring doctor, but that is changing, and radiologists are more often taking on that role.”

Some medical practices share results via fax, but phone and email take precedence nowadays. Whitley notes doctors may also receive images via a smartphone or an iPad, increasing the efficiency of communication.

Safety and security
For many, the news that they must undergo an MRI produces some anxiety. In the earlier generation of MRI systems, the patient had to lie down, then his or her body was passed through a closed tube. The tests can be noisy, as electric current reacts to the magnetic field.

The development of open MRI scanners helped prevent the feeling of claustrophobia that plagues some patients. However, in their early years, many doctors felt the images were not as clear. Fortunately, that has changed dramatically in recent years, doctors say.

“Maybe 15 years ago, in order to get the best image, you had to give up on the open MRI,” Whitley says. “Today, if you get the best machines, open can be just as good.”

Dr. Ross Titton, an MRI specialist with Booth, says the practice uses machines with the widest appropriate “bore”—the size of the opening of the tube.

“All of our magnets are relatively open-bore,” he says. “We don’t want the patients to feel that they are too closed in.”

Muhr says patients who remain anxious may be prescribed a mild sedative, in which case they should arrange for someone to drive them to and from the appointment. It’s important to be calm so that the technicians can capture accurate images.

“The tests today can be done fairly quickly and efficiently,” he says. “The more still and calm the patient is, the more accurate the test will be and the more quickly we’ll be able to finish the scan.”

There’s a new development in MRI that offers patients another option. Upright MRI of Cherry Hill does not use a tunnel at all; patients sit or stand for their test. They are even invited to watch TV while undergoing their scans.

Marge Beck, of Upright’s marketing department, says the ability to evaluate patients while they are bearing weight can make a big difference in finding and diagnosing problems. For example, a spinal cord injury may not be as visible if a patient is lying down, but may present itself if the patient stands. The practice’s Fonar Upright MRI scanner is appropriate for patients ages 8 and up, and weighing up to 500 pounds.

There are a few precautions that should be taken before any kind of MRI: Patients may not wear anything with metal on it, so watches and jewelry should be left at home. Also, the magnets may wipe out credit cards and bank cards, so those should be left outside the room. Patients with metal inside their bodies, like pacemakers, may not undergo MRIs. Doctors and office staff are well equipped to answer questions surrounding the procedure.

Success stories
“Over the past 20 years, there have been amazing advances in the technology,” Whitley says. “Ultrasounds have gone from a very basic tool to one that can evaluate blood flow. They can even be used to guide biopsies. MRI can now be used to evaluate how the heart and lungs function.”

Muhr says improved technology has led to more accurate diagnoses of many health problems. One example: appendicitis.

“Before we developed cross-sectional scans, it was a tough diagnosis, and many times, the appendix was removed unnecessarily. Now, thanks to improved scans, the rate of negative appendectomy is down to nearly nothing.”

Breast imaging has also benefited tremendously from innovative technology, such as the tomosynthesis, or 3D mammography, offered by SJRA.

“Mammography is the greatest success story in radiology and it has been the single biggest factor in improving breast cancer outcomes,” Muhr says. “The 3D scan provides much more detailed images from a scan that is much less invasive to the patient.”


South Jersey Radiology Associates
Serving South Jersey
1 (888) 909-SJRA (7572)

Booth Radiology
Locations in Washington Township, West Deptford and Woodbury
1 (877) BOOTH-99

Upright MRI
701 Route 38 E.
Cherry Hill
(856) 486-9000

Published (and copyrighted) in the Art of Living Well pull-out section of Suburban Family Magazine, Volume 4, Issue 4 (June, 2013).
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