CT
Computed tomography, CT, also referred to as CAT scan, uses specialized x-ray equipment to obtain images of the body. Images from different angles are taken and then joined together to show a cross-section of body"’s tissues and organs. The CT scanner emits and records x-ray beams for the duration of the scan. A special computer program is then used to form cross-sectional images, or slices of the area scanned. These slices are called tomograms.

CT scans are used in the diagnosis and assessment of head injuries, stroke, clots in the lungs, appendicitis and many other conditions and diseases.

Ct is also used in screening such as virtual colonoscopy and in radiotherapy treatment planning.
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DEXA
DEXA (Dual-Energy X-ray Absorptiometry) is an x-ray exam which is used to measure your bone strength or bone mineral density. Osteoporosis is one of the conditions that can cause loss of bone mass. Bones that are not very dense can become weak and are more likely to break.

Density measurements are taken of bones at specific areas of your body. Usually at the lower back, hip, wrist or forearm. The results show whether you have lost bone density. The measurements also help determine the presence of osteoporosis and can be used to estimate your risk of a possible bone fracture. If you are being treated for bone loss, a follow-up exam can also show if the therapy is working.

There is little or no preparation for this exam. Please do not take any calcium supplements 24 hours prior to the exam. Dress comfortably but try to avoid clothes with metal zips, buttons or belts.
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FLUOROSCOPY
Fluoroscopy is a form of diagnostic radiology used to obtain "real-time" images of the internal structures of the body.

Often a contrast agent, also known as contrast media such as barium is administered to aid in the evaluation.

Some of the most common fluoroscopy studies are:

Oesophagram (Barium Swallow) and Upper Gastrointestinal Series (UGI) which examines the oesophagus, stomach and the first part of the small intestine (bowel).

Small Bowel Series which examines the small intestine (bowel).

Barium Enema or Lower Gastrointestinal Series (Lower GI) which examines the large intestine (bowel) or colon.

Fluoroscopy is used to screen for ulcers, benign tumours (polyps, for example), cancer, or signs of certain other intestinal illnesses.
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X-RAY
An X-ray or radiograph is one of the most commonly used techniques in Radiology Services for imaging internal structures of the body.

The images show the differences in densities in the body. Bone has a high density so it absorbs more x-rays and shows up "light" on the images. X-rays pass readily through the air in the lungs so they show up "dark".

The differences in shading between the densities allows x-rays to outline organs, show abnormalities and find disease locations.

Radiographs are an accurate and reliable way of obtaining helpful information in the diagnosis and treatment of many diseases, conditions and injuries.

Minimal doses of radiation are used to achieve optimal results. All x-ray examinations are well within permissible levels of diagnostic radiation.
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Click on one of the links below to download an information leaflet








INTERVENTIONAL RADIOLOGY
Interventional Radiology also referred to as Special Procedures, is a specialty dedicated to the practice of imaging guided procedures for diagnostic and therapeutic purposes.

Angiography, for example, is one of the many procedures within Interventional Radiology.

Angiograms provide x-ray images of arteries or veins for diagnostic purposes. Angiography is frequently used to detect narrowing, blockage, and damage to arteries, bleeding sites and tumours. It is also used to study the blood vessels in the arms, legs, heart, lungs and circulation in the brain.

All interventional procedures are performed by specially trained Radiologists.

Angioplasty, biopsies and many other procedures are included in interventional radiology.

Interventional radiology plays a major role in quality healthcare.

Common Interventional Procedures:

• Angiography: An X-ray exam of the arteries and veins to diagnose blockages and other blood vessel problems; uses a catheter to enter the blood vessel and a contrast agent (X-ray dye) to make the artery or vein visible on the X-ray.
• Balloon angioplasty: Opens blocked or narrowed blood vessels by inserting a very small balloon into the vessel and inflating it. Used by IRs to unblock clogged arteries in the legs or arms (called peripheral vascular disease or PVD), kidneys, brain or elsewhere in the body.
• Biliary drainage and stenting: Uses a stent (small mesh tube) to open up blocked ducts and allow bile to drain from the liver.
• Central venous access : Insertion of a tube beneath the skin and into the blood vessels so that patients can receive medication or nutrients directly into the blood stream or so blood can be drawn.
• Chemoembolization: Delivery of cancer-fighting agents directly to the site of a cancer tumor; currently being used mostly to treat cancers of the endocrine system, including melanoma and liver cancers.
• Embolization: Delivery of clotting agents (coils, plastic particles, gel, foam, etc.) directly to an area that is bleeding or to block blood flow to a problem area, such as an aneurysm or a fibroid tumor in the uterus.
• Fallopian tube catheterization: Uses a catheter to open blocked fallopian tubes without surgery; a treatment for infertility.
• Gastrostomy tube: Feeding tube inserted into the stomach for patients who are unable to take sufficient food by mouth.
• Hemodialysis access maintenance: Use of angioplasty or thrombolysis to open blocked grafts for hemodialysis, which treats kidney failure.
• Needle biopsy: Diagnostic test for breast, lung and other cancers; an alternative to surgical biopsy.
• Radiofrequency ablation: Use of radiofrequency (RF) energy to "cook" and kill cancerous tumors.
• Stent: A small flexible tube made of plastic or wire mesh, used to treat a variety of medical conditions (e.g., to hold open clogged blood vessels or other pathways that have been narrowed or blocked by tumors or obstructions).
• Stent-graft: Reinforces a ruptured or ballooning section of an artery (an aneurysm) with a fabric-wrapped stent C a small, flexible mesh tube used to "patch" the blood vessel. Also known as an endograph.
• Thrombolysis: Dissolves blood clots by injecting clot-busting drugs at the site of the clot, often used for treating deep vein thrombosis and stroke.
• TIPS (transjugular intrahepatic portosystemic shunt): A life-saving procedure to improve blood flow and prevent hemorrhage in patients with severe liver dysfunction.
• Uterine artery embolization: An embolization procedure of uterine arteries to stop life- threatening postpartum bleeding, potentially preventing hysterectomy. The same procedure is used to treat fibroid tumors and is then called UFE (Uterine Fibroid Embolization).
• Uterine fibroid embolization: An embolization procedure of uterine arteries to shrink painful, enlarged, benign tumors in the uterus, also called UAE (Uterine Artery Embolization).

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MAMMOGRAPHY
Early detection and diagnosis can provide successful treatment of breast cancer. Mammography plays a major role in early detection. This low dose x-ray imaging shows changes in the breast before you or your physician may feel them.

There are two types of mammography imaging, screening and diagnostic.

Screening mammography is utilized for the early detection of breast cancer in those with no symptoms or complaints. Generally, screening is recommended for women between 40 and 50 years of age. This can depend on family history and other factors.

Diagnostic mammography is utilized for the detection of breast cancer in those who have a breast complaint, such as a lump found during self examination. It is also used to follow-up on abnormalities found in screening mammograms. Diagnostic mammography can be more involved and time-consuming than screening mammography.

Compression of the breasts during the exams is necessary for maximum quality images. This compression may be slightly uncomfortable, but it only lasts for a short time.
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MRI
Magnetic Resonance Imaging, more commonly referred to as MRI" is a type of scan which uses magnetism to obtain pictures of the inside of the body.

MRI has proven very valuable for the diagnosis of a broad range of disorders and conditions. MRI requires specialized equipment and allows evaluation of some body structures that may not be as visible with other imaging methods.

MRI is generally the most sensitive exam for spinal and joint problems and is used to diagnose sports injuries. Radiologists are able to see very small injuries and tears to muscles and ligaments, especially affected areas such as the knees, shoulders, hips, elbows and wrists.

MRI is also used for diagnosing some heart conditions and helps determine the extent of damage caused by a heart attack or progressive heart disease. Before the scan you will be asked about your medical history. Most importantly, information in regards to metal objects. This includes pacemakers, pins or plates, surgical clips and cochlear implants (for deafness) and others. If you have any body piercing, you will have to remove them before your scan.

If you have ever performed metalwork or think you may have any metal fragments anywhere, you may need to have an x-ray before your MRI.
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NUCLEAR MEDICINE
Nuclear Medicine is the use of very small amounts of radioactive material to diagnose and even treat certain diseases.

Nuclear Medicine is safe and carries about the same risk as a common x-ray.

Its use can help detect a wide variety of conditions such as infection, arthritis, blood clots, heart disease, thyroid disease, stress fractures, and cancer.

For many diseases, Nuclear Medicine studies provide the most useful information necessary to make the proper diagnosis and to determine appropriate treatment.

The main difference between Nuclear Medicine imaging and other X-Ray tests is that Nuclear imaging assesses how organs function, whereas others imaging methods assess anatomy, or how the organs look.

The functional information provided by Nuclear Medicine procedures is unique and currently unattainable by using other imaging procedures.

Radiopharmaceuticals (imaging agents) are given in several ways: by intravenous injection, inhaled, by swallowing capsules or a solution. The imaging agent travels to specific organs and tissues dependent on what procedure has been requested. Different agents go to different organs which in turn give off gamma rays.

The camera detects these rays and provides images of the specific organs and tissues.
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Click on the link below to download the Nuclear Medicine information leaflet




PET/CT
PET/CT stands for Positron Emission Tomography/Computed Tomography. It combines the metabolic functional information from the PET scan with the anatomical information from the CT image fused into one three dimensional examination of the body.

Its use can help diagnose cancer cells, evaluate lesions treated by radiotherapy or chemotherapy and differentiate between inactive necrotic tissue or scar and lesions.

PET scans can also be used to determine the blood flow to the heart and the brain.

PET uses a small amount of radioactive tracer, Fluorine (FDG) which is added to glucose.

The tracer (FDG) is administered by injection to the patient. Since many cancer cells are highly metabolic, the tracer will accumulate with the glucose at a greater rate than the normal surrounding tissues.

This radioactivity from the tracer emits positrons as it decays, which are in turn detected by the PET camera. This functional information is then superimposed to the CT image to produce a high quality image of diagnostic accuracy.
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RADIOTHERAPY
Many patients who have been diagnosed with cancer may have Radiotherapy as part of their treatment plan. Radiotherapy can be given externally, from outside the body, using x-rays or electrons.

This type of treatment can also be given internally, from within the body, by placing radioactive material close to or in a tumour. The linear accelerator is the most common type of machine used for external radiation therapy.

In the treated area, radiotherapy destroys cancer cells. Normal cells are also affected, but can repair themselves. Treatments can be given over days or weeks, usually on a Monday to a Friday schedule with weekends off to help the repair of normal cells.

With professional expertise the risks of radiotherapy are small however, the benefits are numerous.
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ULTRASOUND
Ultrasound, also referred to as sonography, is the process of obtaining images from inside the body through the use of high frequency sound waves.

Everyone is mostly familiar with ultrasound because of its use during pregnancy. These images are used to determine foetal growth, overall health and the sex of the foetus.

This type of imaging also allows radiologists and physicians to visualize structure, observe blood flow and tissue movement in the body"’s organs and blood vessels. All of which are necessary to diagnose many illnesses.

Since ultrasound emits no x-rays, it is very safe. There are no known risks or side effects associated with diagnostic ultrasound.
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Who are the Radiologists reading my study?

Our Radiologists are medical specialists in diagnostic imaging services and board certified by Royal College of Surgeons in Ireland.

They are also U.S. trained and hold the necessary licenses, insurance and credentials for our hospital.

Their specialties include Interventional Radiology, Mammography, CT, MRI, Nuclear Medicine, PET/CT, DEXA and Ultrasound.
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Are x-rays safe?

The chance that x-rays will be harmful is very low, mainly because the amount of radiation used in an x-ray examination is very small.
There is no definite number as to how many x-rays are safe or dangerous.
The risk of not having a needed x-ray is greater than the tiny risk from the radiation.

You should tell your Doctor or the Radiographer performing your x-ray examination if you think you are or think you might be pregnant.

If you or your children are having x-rays, ask for a lead shield. A lead shield can be used to cover your reproductive organs as well as your thyroid.

A shield cannot always be used though, particularly around the pelvis because it may interfere with the area that the Radiologist needs to see.

The general consensus within the medical community is, the benefits of diagnostic imaging by far, outweigh the limited amount of radiation associated with these types of procedures and studies.
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How long does a CT scan usually take?

CT scans take approximately 20 minutes depending on the specific order from your Doctor.
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How should I reschedule or cancel my appointment?

Please call your Doctor or the Radiology Services Department if you need to reschedule or cancel your appointment.

A 48 hour notice of cancellation or rescheduling would be appreciated. This allows other patients the opportunity to fill that appointment.

Why should I have my studies done at UPMC Beacon Hospital?

The Radiology Services Department of UPMC Beacon Hospital is one of the most advanced imaging centers in the area.
You will receive the best quality care from our highly-trained and patient-oriented staff.
Our department adheres to specific and strict quality assurance programs for all equipment.

Will the radiographer be able to tell me the results of my x-rays?

The radiographers are specially trained to take your x-rays, but are not qualified to read your x-rays.

How long does a PET/CT scan usually take?

PET/CT scans usually take between 2 and 2 1/2 hours.

Is there any preparation for a PET/CT scan?

Yes! After midnight, you cannot have anything to eat or drink, with the exception of water. You will receive any other specific instructions when your appointment is made.
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I've had different types of surgery, is it still safe to have an MRI scan?

When you arrive to UPMC Beacon Radiology MRI Department, the trained radiographers will help you complete a safety questionnaire prior to the scan. 
They will determine the safety of carrying out the procedure based on the surgical information that you will provide to us.

Some implanted devices, such as stents, clips or hip replacements typically become firmly incorporated into the body tissue up to 8 weeks following their placement. 

Interventional Procedures for Cancer
(Interventional Oncology)

The three Interventional Radiologists at UPMC Beacon Hospital, all of whom are highly experienced, with North American training, perform approximately 2500 interventional procedures per annum. The following interventional procedures for cancer are available at UPMC Beacon Hospital Dublin

Chemoembolization
Applications: Primary Liver Cancer (Hepatocellular Carcinoma)
Secondary Liver Cancer (Colon, Breast, GI tract, Neuroendocrine)

Chemoembolization is a method used to deliver chemotherapy medication directly to liver tumours – either primary tumours that originated in the liver, or metastases that migrated to the liver from cancers at other sites, such as colon, neuroendocrine tumours and breast. Even in cases where chemoembolization is not curative, this approach relieves patient's symptoms and extends survival.

The procedure is performed by inserting a catheter into a blood vessel in the patient's groin and advancing it into the specific artery supplying the liver. Contrast, or a special type of dye, is injected and this visualises the tumour and blood vessels on an X-ray to determine the blood supply to the tumour.

The Interventional Radiologist then injects cancer-drug eluting embolic particles through a catheter selectively placed into the artery feeding the tumour. This mixture keeps a high concentration of medication in contact with the tumour for a period of time longer than that associated with traditional systemic chemotherapy. After the treatment is administered, the catheter is withdrawn, and the patient can usually return home after an overnight stay in the hospital. Chemoembolization offers several advantages over traditional systemic chemotherapy: Prolonging the time the medication stays in contact with the tumour – up to as much as a month – increases the treatment's effectiveness. Moreover, because the medication is delivered only to the tumour – rather than administered throughout the patient's bloodstream – healthy tissues are spared from side effects, allowing us to administer dosages that are greater than those used in conventional chemotherapy, without the systemic side effects. New embolic particles not only hold the chemotherapeutic medication in place, but also block the blood supply to the tumour – depriving it of oxygen and nutrients and thereby halting its growth.

The UPMC Beacon Hospital Interventional Radiology Group have particular expertise in the treatment of colon-related liver metastases by combination emobolization and RF ablation therapy which has now become a gold standard for treatment of non-operable metastases.

Tumour Ablation
Applications: Primary Liver Cancer (Hepatocellular Carcinoma); Primary Lung Cancer; Primary Renal Cancer; Primary Bone Cancer, Secondary Liver Cancer (Colon, Breast, GI tract, Neuroendocrine); Secondary Bone Cancer; Secondary Adrenal Cancer

UPMC Beacon Hospital Interventional Radiologists are also using interventional radiology techniques to apply heating, or substances such as acetic acid or ethanol directly into tumours as a means of killing cancer cells. This type of treatment, called tumour ablation, is a relatively new technology that is showing promising results for treating cancers of many different types.

Radiofrequency ablation (RFA) offers a nonsurgical, localised treatment that kills the target tissue with heat, while sparing the healthy tissue. Because of the localised nature of this treatment, RFA does not have any systemic side effects. Radiofrequency ablation can be performed without affecting the patient's overall health and most people can resume their usual activities in a few days.

In this procedure, the Interventional Radiologist uses imaging to guide a small needle through the skin into the tumour. From the tip of the needle, radiofrequency energy is transmitted into the target tissue, where it produces heat and kills the tumour. Preliminary studies have demonstrated that RFA significantly reduced bone pain from metastatic disease in over 90 percent of patients who had failed or were not suitable candidates for conventional therapy. In these studies, there were only a few patients who suffered any side effects or complications. Therefore, RFA was demonstrated to be safe and effective in selected patients. A multicentre clinical trial is underway to further investigate the role of RFA in management of painful bone metastases.

During the procedure, using a CT scanner or ultrasound machine, a small needle-like device is inserted into the tumour through a tiny nick in the skin. The doctor watches this probe as the images are projected with the CT scanner or ultrasound machine onto a viewing screen so that the probe can be precisely guided into the tumour. The probe is then attached to an energy source that delivers heat (using radiofrequency, laser, or microwave energy) or freezing (a treatment called cryoablation), or a special needle (infusion needle) that allows the tumour to be injected with a tumour- destroying substance.

Relief of Organ Obstruction
Many cancers can grow to the point where they obstruct the normal flow of urine or bile, causing these fluids to build up in the body. Without treatment, such obstructions can cause not only pain, but infection or even liver or kidney failure. Interventional Radiologists at UPMC Beacon Hospital Dublin can insert an X-ray-guided catheter into the obstructed area to drain excess fluids. They may also insert a stent – a tiny wire mesh tube – into the organ to bypass the obstruction and permit fluids to drain normally. This is important in cases of palliative care.

Treating Blood Clots and Bleeding One common side effect of cancer or cancer treatments is the development of blood clots, or emboli, that can be life-threatening if they travel to the brain, lungs or heart. There are two interventional radiology procedures that can reduce the risks posed by blood clots:

Intra-arterial thrombolysis. In this technique, the Interventional Radiologist guides a catheter through the blood vessels and to the site of a blood clot. Clot-busting drugs are infused through the catheter to break up the clot.

Filter placement. This technique is most often used when a blood clot is detected in the blood vessels of the leg (a condition called deep vein thrombosis). The Interventional Radiologist guides a small filter into the blood vessel that receives blood from the lower body (the vena cava) and carries it to the heart. If the blood clot dislodges from the vein in the leg, the filter will trap it before it can reach the heart.

Controlling Bleeding: If a cancer spreads to the blood vessels it may cause hemorrhage or bleeding. An interventional radiology technique called transcatheter embolisation can be used to clot the affected blood vessels and stop the bleeding.

Tumour Biopsy
Many cancers are now diagnosed by needle biopsy. During this procedure, we use imaging techniques (such as CT, X-ray, ultrasound, or MRI) to guide the insertion of a fine needle into the patient's tumour. A small amount of tissue is removed and then examined by a pathologist to determine if cancer cells are present. Needle biopsies are less painful, less disfiguring, and result in a shorter recovery time than conventional surgical biopsy procedures. Needle biopsy, also called image-guided biopsy, is usually performed using a moving X-ray technique (fluoroscopy) computed tomography (CT), ultrasound or magnetic resonance (MR) to guide the procedure. In many cases, needle biopsies are performed with the aid of equipment that creates a computer-generated image and allows radiologists to see an area inside the body from various angles. This "stereotactic" equipment helps them pinpoint the exact location of the abnormal tissue. Needle biopsy is typically an outpatient procedure with very infrequent complications; less than 1 percent of patients develop bleeding or infection. In about 90 percent of patients, needle biopsy provides enough tissue for the pathologist to determine the cause of the abnormality.

• With image guidance, the abnormality can be biopsied while important nearby structures such as blood vessels and vital organs can be seen and avoided.
• The patient is spared the pain, scarring and complications associated with open surgery.
• Recovery times are usually shorter and patients can more quickly resume normal activities.

Palliation - Interventional Radiologists Can Help Reduce Pain and Improve Quality of Life
Bones are the third most common location where cancer cells spread and metastasize. Bone metastases occur when cancer cells gain access to the blood stream, reach the bone marrow, begin to multiply and then grow new blood vessels to obtain oxygen and food – which in turn causes the cancer cells to grow more and spread. Some bone metastases become painful because the tumour eats away at the bone, creating holes that make the bone thin and weak. As the bones are replaced with tumour, nerve endings in and around the bone send pain signals to the brain. If left untreated, bone metastases can eventually cause the bone to fracture – seriously affecting a patient's quality of life. This is particularly true for long bones of the extremities where a fracture may render a limb non-functional. These patients may require surgical intervention to restore the function of their limbs. More commonly, metastases involve the ribs, pelvis, and spine.
For the most part, the goal of treating bone tumours is not curative, but rather palliative by reducing pain, preventing additional bone destruction, and improving function. In treating cancer patients with painful bone metastases, Interventional Radiologists may use one of the two different thermal ablation techniques – radiofrequency ablation and cryoablation. This form of therapy is aimed at desensitising the bone by killing the nerve endings in the vicinity of the metastasis. They can also treat painful vertebral metastases or fractures with vertebroplasty.

Vertebroplasty
The spine is one of the most common sites of metastasis. Vertebral bodies involved by the tumour may become painful and may eventually fracture. Surgical intervention with reconstruction of the spinal column is indicated only if the tumour causes compression of the spinal cord or instability of the spine. Vertebroplasty is an outpatient procedure performed using conscious sedation. An Interventional Radiologist inserts a needle through a small incision in the back, directing it under fluoroscopy (continuous, moving X-ray imaging) into the fractured vertebra. The physician then injects a medical-grade bone cement into the vertebra. The cement hardens within about 15 minutes and stabilises the fracture. This treatment reduces pain, prevents further collapse of the vertebra, and restores mobility. Vertebroplasty dramatically improves back pain within hours of the procedure, provides long-term pain relief and has a low complication rate, as demonstrated in multiple studies.