Advances in radiologic technology play an important role in diagnosing medical conditions and diseases. Since Wilhelm Roentgen discovered X-rays in 1895, transformations in radiology have been improving the level of healthcare in our community.
State-of-the-Art 3D Mammography
3D mammography – digital breast tomosynthesis – is a revolutionary diagnostic breast imaging tool that improves the detection of early-stage breast cancer, when it is easier to treat.
In the US, 1 in 8 women are diagnosed with breast cancer each year. “Studies show a 10% to 30% increase in overall breast cancer detection using 3D mammography, compared to using 2D imaging alone,” says Robert E. Wold, MD, a board-certified radiologist.
3D mammography also helps to reduce the stress of mammography, especially for the one in four women who are “called back” for additional screenings and possibly invasive diagnostic biopsies.
“3D technology divides the breast into multiple very small slices, thereby removing overlapping tissue,” says Dr. Wold. “Together the images create a crystal-clear 3D reconstruction of the breast.”
Skilled radiologists review a reconstruction of the breast, one slide at a time, almost like turning pages in a book. These comprehensive visual aids radiologists who are experienced with digital breast tomosynthesis to recognize areas of concern. 3D tomosynthesis is especially advantageous in young women and women with dense breasts.
“The American Cancer Society, the American College of Radiology, the American Congress of Obstetricians and Gynecologists and the American Society of Breast Disease recommend a screening mammogram every year for women beginning at age 40,” advises Dr. Wold. Like a conventional mammography, breast tomosynthesis radiation levels are well below the limits defined by the FDA.
“Women who have a strong family history of breast cancer and those who are at increased risk due to a genetic history of breast cancer should begin screening earlier,” concludes Dr. Wold. “Women should know how their breasts normally look and feel, and should report any change immediately to their doctor.”
Prostate MRI Fusion
Prostate cancer rates in men are similar to breast cancer rates in women in the US. The prostate gland, a soft tissue structure about the size of a walnut, lies deep within a man’s pelvis between the bladder and penis, in front of the rectum.
Recent advances in MRI – magnetic resonance imaging – have allowed doctors to evaluate the prostate gland in ways that were previously impossible. Today’s technology improves prostate cancer detection, staging of patients with known prostate cancer and evaluation of recurrent disease in men whose prostate gland has been removed.
“When we started our prostate MRI program in 2012 we were performing one prostate MRI per month. As urologists learned of the power of this test our practice has grown; currently we average more than 90 patients per month,” says board certified diagnostic radiologist Stephen McManus, MD, confirming the growing use of MRI for prostate cancer diagnosis.
MRI uses electromagnetic properties to collect information about organs and other tissues. Cancerous tissue has a different set of magnetic properties than surrounding normal tissue. MRI is able to capture these differences in amazingly clear images.
“To ensure accuracy every prostate MRI is double read by two radiologists, each experienced in this area,” says Dr. McManus. “Additionally, we use 15 data points to illustrate the exact position of any findings.”
Finally, many urologists who perform these biopsies will use state-of-the-art technology called MR-ultrasound fusion biopsy. The MR images are superimposed on the prostate gland at the time of biopsy, which improves accuracy.
“These three critical steps assist the patient’s urologist in identifying targets during the biopsy procedure, increasing the chances that the cancer is sampled,” says Dr. McManus.
“Prostate MRI along with MRI ultrasound fusion biopsy is at the leading edge of prostate cancer care,” says Dr. McManus. “Residents in the greater Monmouth County area are fortunate to have this university hospital-grade technology available close to home.”
CT – Virtual Colonoscopy & Lung Scans
A CT scan – computerized tomography – can help detect lung cancer and colon cancer by providing unobstructed 3D views, enabling early diagnosis, when treatment options have the best chance for success.
“Low Dose CT Scans for lung cancer screening have been shown to decrease deaths from lung cancer by 20%. If you are a current heavy smoker or have quit within the last 15 years, you should talk to your primary care physician or pulmonologist to see if this test is right for you,” says Janet Spector, MD.
“When caught early enough, the survival rate for lung cancer is very high,” explains Dr. Spector. “By the time a lung tumor shows up on a chest x-ray, the cancer will be at a much later stage, much larger, and with an outcome that may be much less optimistic.”
Lung cancer remains the second most common cause of cancer death in the US for both men and women after skin cancer. More men and women die from lung cancer than from colon, breast and prostate cancers combined.
People age 50 and older should get screened for colorectal cancer every five years and, thanks to today’s medical imaging technology, there’s more than one type of colonoscopy.
“Colonoscopy remains the gold standard for colorectal cancer screening and prevention,” says Dr. Spector, “but a less invasive procedure – virtual colonoscopy – has benefits for some patients.”
Patients who should consider virtual colonoscopy include those for whom anesthesia is too risky, or who are simply too fearful of a conventional colonoscopy.
“The best test is a test a patient is willing to have,” affirms Dr. Spector.
There are no dyes, no sedatives, no IV and a lower risk of complications with virtual colonoscopy. Instead of a long tube topped by a camera inserted through the rectum, with virtual colonoscopy only a small disposable tube is used to inflate the colon with carbon dioxide.
A reduced radiation CT scan is taken outside of the body, with the patient lying first on their back and then on their stomach. The CT images clearly show even small polyps and other abnormalities inside the rectum, colon and pelvic area.
Both tests still require a clean colon, so a clear liquid diet and a laxative prep are necessary. If a polyp is found, a conventional colonoscopy is needed to remove the polyp or get a biopsy.
“Colorectal screening is important because it saves lives,” says Dr. Spector. “The most common symptom of colon cancer is no symptom at all. Only a colonoscopy allows us to see it and catch it early, so have a colorectal discussion at your next check-up.
No matter what you choose, don’t put this test off for fear of discomfort.”
Robert E. Wold, MD
Stephen McManus, MD
Janet Spector, MD