Radiology / Imaging Services
They are common fixtures at the dentist’s office or at the airport, but x-rays and imaging technology serve a wide array of purposes and applications. At Durham Regional Hospital, we provide comprehensive radiology services. Our team of dedicated technologists, nurses and radiologists is committed to providing the highest quality care with compassion and service.
Our services include:
- General X-ray
- Bone Mineral Density Testing
- Mammograms
- Ultrasounds
- Radiation Oncology
- CT Scans
- MRIs
- Nuclear Medicine
- Vascular/Interventional Radiology
General X-ray
An x-ray is a medical picture of what is occurring in the body. X-rays are a form of electromagnetic radiation that are emitted by a machine as photons. These photons pass through the body and images are stored electronically in a computer. All x-rays are administered by a registered x-ray technologist and read by a radiologist.
X-rays can be taken of any area of your body to detect problems. The x-ray machine and the positioning of the patient depend on the area of the body being x-rayed.
There is no discomfort from x-ray exposure, but you may be asked to be still and sit in awkward positions for short periods of time.
Bone Mineral Density (BMD)
Bone Mineral Density (BMD) testing determines the density of bones by measuring the amount of calcium in the tested portion. BMD testing uses small amounts of radiation to determine the bone density of the spine and hip. The results are compared with the average BMD of healthy young adults of the same sex at their peak bone mass. This information can help the physician diagnose osteoporosis or determine whether there is a need to take certain steps to protect your health.
A physician may recommend a BMD test to help:
- Confirm a diagnosis of osteoporosis
- Predict future fracture risk
- Monitor the changes in BMD due to medical problems or effects of treatment over time
BMD testing is safe and simple. There is no pain or special preparation associated with the BMD exam.
Frequently Asked Questions:
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What type of machine will be used?
Our new Advanced Lunar Bone Densitometry unit is the device for BMD testing. In addition to measuring BMD, it can also determine:
- Total Body Scan—measures bone status, the lean and total body fat percentages and soft tissue composition
- Low Dose Pediatric—detects growth and metabolic disorders that affect bone development
- Orthopaedic Hip Analysis—examines bone around any type of metal prosthesis
- Dual-energy Vertebral Assessment (DVA)—visualizes vertebral deformities and gives optimal front and lateral (side) views to better identify fractures
- Forearm—assists in the overall bone density measurement for those with severe back or hip problems
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How much radiation will I be exposed to?
You will be exposed to very little radiation. In fact, in most cases, less than a standard chest x-ray. As with any procedure, be sure to inform your physician of the possibility of pregnancy.
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How long does the BMD test take?
Tests of the spine and hip take about 5-7 minutes each including proper positioning.
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What should I wear?
You should wear comfortable clothing, preferably without metal buttons, buckles or zippers.
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What do I do during the examination?
Lie still, breathe normally and rest comfortably.
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Is the test the same as a bone scan?
No. A bone scan, which may help your physician identify certain bone abnormalities such as infection, inflammation or cancer, requires an injection of radioactive material. A BMD test requires no special preparation, medication or injection.
Mammography
A mammogram is a x-ray of the breast. Mammography is performed by a specially-trained radiology technologist. The technologist performs a mammogram by compressing your breast between two plates attached to a specially designed x-ray machine. The breast is then digitally imaged from two separate angles and the results are examined by a radiologist. The results of the mammogram will show the features of the breast and may reveal suspicious areas that require further investigation. Occasionally, women who undergo mammography require magnification or compression views. These views allow the radiologist to better view tiny calcium deposits (microcalcifications) or small masses that are undetectable during a regular breast exam.
Most changes that occur in the breast are first noticed by women themselves. If you practice regular breast self-exams, you are familiar with the look and feel of your breasts and will more than likely notice a change that may indicate a problem.
When a lump (also called a mass or lesion) becomes large enough to feel it is said to be palpable. If you discover a change in your breasts, call your gynecologist or primary care physician to have your breasts professionally examined.
A physician may suspect an abnormal area is nothing more than a mass filled with liquid, more commonly called a cyst. The physician may attempt to aspirate it by inserting a thin needle into the area. If the cyst is aspirated and it does not collapse entirely or if the fluid removed is bloody, it will be examined by a pathologist. If your doctor feels your condition is suspicious and requires further investigation, he/she will then recommend one or more diagnostic procedures.
Mammograms detect most, but not all, breast cancers. Therefore, self-examination and examination by your physician are equally important in breast cancer detection.
The type of mammogram procedure you have will be determined by your physician and yourself. A diagnostic study is usually ordered if you are having pain, tenderness, nipple discharge, soreness, lump(s) or a strong family history of breast cancer. A screening study is usually ordered if you are having no problems or symptoms with your breast.
The American Cancer Society recommends follow up mammograms every one to two years between age 40 and 50 and every year after age 50.
To schedule an appointment for a screening mammogram or a diagnostic mammogram, ask your physician to call (919) 470-8622.
Ultrasound
Ultrasound is high frequency mechanical waves that humans cannot hear. It is widely used in medical imaging for the evaluation of a patient's organs. Ultrasound energy is transmitted into the patient; then, because the various internal structures reflect and scatter sound differently, returning echoes can be used to form an image of a structure.
There are many different uses for ultrasound. Your physician may order an ultrasound if you are pregnant to check the development of your baby. Ultrasound can also be used to evaluate pelvic pain, abdominal conditions, cysts or other masses and shoulder pain, or to evaluate blood flow through your arteries or veins.
Radiation Oncology
Radiation Oncology is the medical specialty concerned with the treatment of cancer with radiation. Approximately 50 percent of all cancer patients receive radiation as part of their treatment. Durham Regional Hospital's Radiation Oncology Clinic treats breast, prostate, lung, head and neck, gastrointestial and skin cancers as well as lymphoma, brain tumors and palliation for metastatic disease. Since opening in November 1996, the Radiation Oncology clinic has seen 5000 new patients, and delivered more than 54,400 radiation treatments.
Radiation is delivered by a linear accelerator. A new state-of-the-art linear accelerator machine was installed in 2008. The machine has the ability to:
- Use electrons or photons for superficial or deep penetration. Photons are used to treat most common malignancies that are deep-seatedsuch as those in thelung, abdomen, pelvis, head and neck. Electron energies are used to treat more superficial cancers such as skin, lymph nodes and surgical scars.
- Perform Intensity Modulated Radiotherapy, which helps reduce side effects from treatment.
- Improve target accuracy by imaging patient on the treatment table (diagnostic quality X-ray or CT)
- Perform Stereotactic Radiation Therapy, which provides focused conformable high dose treatments for recurrent or inoperable tumors.
- Match treatment to breathing cycle to minimize tumor or organ motion.
The Radiation Oncology clinic is a cooperative effort between Durham Regional Hospital and Duke University Medical Center, and is staffed by Duke physicians, therapists, dosimetrists and physicists.
Services are provided Monday through Friday between the hours of 8 a.m. and 4:30 p.m. to both in- and outpatients. Typically, treatments take up to 15 minutes and are given daily over several weeks. Free, reserved parking is available just outside the Radiation Oncology entrance.
CT Scan
CT stands for Computerized Tomography. CT has been used for aiding in diagnoses at Durham Regional Hospital since 1978. The CT scanner uses a combination of x-rays and computers to create cross-sectional images of the body.
A simple analogy to describe how a CT scanner works compares with slicing a loaf of bread. The body part to be examined is scanned in sections like slices in a loaf of bread. One slice at a time is displayed.
The study is painless. The patient feels nothing but a table moving in small increments through a big round hole. This is not a "tunnel", it is just a hole (open on both sides). The scanner will not touch the patient or impair his/her breathing during the procedure.
CT scans can be ordered on any body part. For example, CT examinations are routinely performed on the head, the chest/abdomen/pelvis, extremeties and blood vessels within the body. Most abdomen/pelvis studies require that the patient drink an oral prep prior to the procedure. Some studies require an injection of x-ray contrast. This is an iodinated "clear" liquid material. This material temporarily changes the density of the blood vessels and the blood supply to the organs to enhance their appearance for better visualization. The radiologist determines if x-ray contrast is necessary. Common sensations associated with an x-ray dye injection include: a cool sensation going up the arm that contains the IV, followed by a warm flushed sensation across the rest of the body, and a metallic taste in the mouth. In very rare events, some patients become nauseated. All of these sensations only last about a minute or so and then disappear. Some patients feel nothing at all. The contrast dyes currently used in the x-ray department rarely cause these sensations.
In 2010, Durham Regional Hospital became equipped with two 64-slice CT scanners, which allow radiologists to image the heart, brain, or lungs in only a few seconds. Capabilities of these new scanners include CT angiography, which enables physicians to view arteries in the brain, heart, and peripheral vascular system in greater detail than before; and CT brain perfusion studies to evaluate blood flow to the brain in potential stroke patients.
The CT scanners may also be used to image vessels in the legs to look for blood clots. Both scanners are also bariatric rated, with larger bores and high capacity tables able to accommodate patients up to 660 pounds. The scanners are equipped with technological advances which enable scans to be obtained with the best possible resolution at the lowest radiation dose allowable for diagnostic images.
MRI
Magnetic Resonance Imaging, or MRI, is similar to CT (Computed Tomography) because it produces sectional and 3-D images. MRI uses magnetic energy and radio waves instead of x-rays. During an MRI exam, you lay on a table surrounded by an open-ended magnetic tube. A metal coil is placed above the area being examined. It is like being in a tunnel.
With MRI, your body (which is mostly water), behaves like a radio system. Powerful magnetic energy lines up the body's hydrogen ions, which give off a signal similar to a radio frequency. The technologist "tunes in" to the ion signals with the metal coil, which acts like a receiving antenna. A computer then translates the signals to produce an image. MRI is particularly effective at showing certain types of cancer, herniated spinal disks, and connective tissue damage such as torn ligaments.
What to expect during an MRI exam:
Upon arriving at the MRI department, you will be greeted by an MRI Technologist who will ask a series of questions and have you fill out a screening form. After removing all your metal objects and changing into a gown and robe, you will be escorted to the MRI scan room. Once in the scan room, you will lie on a padded table. You will then be given earplugs to reduce the noise that you will hear. When the scanner is operating you will hear a "thumping" noise and may feel a slight vibration. While the machine is "thumping" it is very important that you hold still since this is the time the scanner is taking pictures. During the entire examination you will be able to communicate with the technologist.
Some patients are given a contrast agent injection in their arm prior to the MRI. This substance improves the contrast of the pictures. It is unrelated to iodine used for CAT scans and kidney x-rays. Prior to the injection, you will be screened to make sure you are eligible for the contrast.
After the MRI, your referring physician will receive a report within 24-36 hours after your scan is completed.
Nuclear Medicine
Nuclear scans can help detect diseased tissue before it can be seen on routine x-rays. Earlier diagnosis means earlier and more effective treatment.
There are many types of nuclear medicine scans: 1) bone scans can detect fractures, infections, tumors and metastasis; 2) thyroid scans reveal relative thyroid functions; 3) ventilation/perfusion scans are used to evaluate the risk of blood clots in the lungs; 4) cardiac scans show the heart as it beats, measure blood flow and heart function, and can detect a recent heart attack; and 5) liver and gallbladder scans can help diagnose cirrhosis, tumor and gallbladder disease.
Nuclear medicine procedures are safe, effective and painless. They are performed by highly trained physicians and technologists. A small amount of radioactive material, called a radiopharmaceutical, is introduced into the body. All radiopharmaceuticals are manufactured under extremely strict government standards and are administered in the smallest possible dose needed to achieve good imaging results. The radioactivity is quickly eliminated from the body after the test is completed, usually through the urine. Depending on the type of test, the material may be injected, inhaled or swallowed. The radiopharmaceutical chosen and the means of administering it depend upon the part of the body being scanned. A certain length of time (several minutes to two days) after the radiopharmaceutical is given, a gamma camera records the amount of radioactivity (gamma rays) remaining in the body. A computer usually assists the calculations and forms the actual image.
Vascular/Interventional Radiology
Durham Regional Hospital’s team of three interventional radiologists and a vascular surgeon works together to provide the most advanced techniques to treat both vascular and nonvascular diseases. Vascular or interventional radiology used minimally invasive approaches without the need for large surgical incisions or general anesthesia. Click here to learn more about Vascular/ Interventional Radiology services at Durham Regional Hospital.
