Diagnostic Services

Somatom Force is the fastest CT scanner made by Siemens. What does this mean to the patient? We can scan the entire chest and abdomen of any patient in just one second! This means that we rarely have “blurred pictures” because of patient movement. This is of great benefit when scanning small children or elderly patients. The Somatom Force can scan 737 mm length per second.

The speed of this scanner allows us to see the arteries supplying the heart (coronary arteries) very clearly without the need to slow the heart down with drugs. This lets us do CT Coronary angiography to look for blocks in these arteries which can cause myocardial infarction (Hear Attacks). This procedure now needs just a few minutes and can be done in all kinds of patients.

This scanner also has a unique ability to find and analyse kidney stones so that the treating surgeon can decide how to treat them. This is possible because of “Dual Energy scanning”. In many cases this can also help in diagnosing joint disease.

This scanner has very low radiation dose for scanning. This is important, because many patients need repeated scanning, and radiation reduction is very important. This can reduce the radiation dose in lung studies by almost 50%.

Very low dose of contrast medium injection is required with an advanced scanner like this. The dose is almost half that required for older scanners with 64 slice.

The Siemens MRI at Sir HN Reliance Foundation Hospital is one of the latest models with a 3Tesla (3T) magnet and advanced technologies. This scanner has advanced neuroimaging, musculoskeletal, breast, and cardiac imaging capabilities. With consultants who are experts in using the latest techniques.

The advanced capabilities include Functional MRI, Cardiac Imaging, MR elastography, Advanced Liver Imaging etc.

• BONE DESITY TESTING
• The weight of our entire body is borne by the bones that make up our skeletal system. Every movement needs muscles that move the bones to allow us to stand and walk. The strength of the bones, particularly in the important weight bearing areas, is very important in preserving health and quality of life.
• The measurement of bone density allows us to learn what the risks are of breaking a bone. For many reasons some persons may have reduced bone density, and this increases risk of fractures, and these fractures can take away the ability to lead a healthy and fulfilling life.
• The measurement of bone density is done using a technique called as Dual Energy X Ray Absorptiometry (DEXA). The equipment can measure many things in the composition of the body and the bone. Such a measurement allows us to decide your risk of having fractures and whether you need specific treatment to improve the strength of the bones.

• What can DEXA testing do?
• This test can :
• Tell you if you have reduce density of bones
• Predict you risk of having a fracture in the future
• Measure if the bone density is improving or getting worse
• In case treatment is started for the condition, measure if it is working

• Who Should Be tested?
• Anyone with a fracture who in the opinion of the doctor may have reduced bone density
• Women after menopause, particularly if they have risk factors
• Men over 70 or even earlier if they have certain risk factors.
• Patients with X-Ray of the spine which shows a break or bone loss
• Patients with back pain
• Patients with height loss

• When should the test be repeated?
• If you are on medicines for a problem with bone density, the test is to be repeated once an year or once every two years at the very least. Your doctor will decide how often you need testing in a given situation.

• BREAST IMAGING

• At Sir H N Reliance Foundation Hospital, we use specialized imaging to aid in early detection of breast diseases. We have a dedicated multidisciplinary team offering digital mammography, breast tomosynthesis (3D mammography), sonomammography (breast ultrasound), breast elastography, breast mass biopsies, sonography and mammography guided hook-wire placements, breast MRI etc.

• MAMMOGRAPHY:
• What is a mammogram?
• A mammogram is a specialized X-ray of the breast showing small details of breast tissue performed by a trained technician who properly positions and compresses the breasts. It is performed both as a screening test and as a diagnostic exam.

• What are the benefits – why should I undergo this test?
• The early detection of breast cancer can lead to early treatment. Mammograms can detect breast changes which may or may not be felt during a physical examination, including small changes requiring further investigation. The images are then interpreted by a radiologist.

• When should I get a mammogram?
• A screening mammogram is used to detect early breast cancer in women with no symptoms. Screening mammography can begin at age 40 (according to latest American College of Radiology and Society of Breast Imaging guidelines), but some women at high risk of breast cancer may need to start earlier. Discussion with your doctor about your risk for breast cancer and when you should get screened would be worthwhile.
• Diagnostic mammogram is done to evaluate abnormal clinical findings, such as a breast lump, nipple discharge that have been found by the woman or her doctor. Diagnostic mammography may also be done after an abnormal screening mammogram to further evaluate the area of concern.

• What is breast tomosynthesis or 3D mammography?
• Breast tomosynthesis or 3D mammography is a newer technique wherein multiple slices of entire breast are taken to better aid in pin pointing size, shape and location of an abnormality. World wide research shows better cancer detection rates and a decrease in call backs as compared to conventional 2D mammography.
• Here, at Sir H N Reliance Foundation Hospital & Research Centre, we have a state-of-the-art Siemens Mammomat equipment with low dose 3D tomosynthesis.

• Is a referral letter needed to get a mammogram?
• A screening mammogram can be scheduled without a referral letter, however, a diagnostic mammogram typically requires one.

• What are the risks?
• Mammograms typically involve a small radiation dose, thus the health risk is very low. The radiation does not remain in the patient’s body after the test. The benefits of detecting small tumors far outweighs the risk associated with radiation exposure.

• Are there any alternatives?
• In case you are pregnant or breast feeding, it is vital to inform prior to undergoing the mammogram. Other appropriate alternative like an ultrasound scan may be performed, if deemed pertinent.

• What I need to do prior to undergoing the mammogram?
• No fasting is required.
• Please bring all your previous investigations (films and reports) when you come for the test.
• You will be asked to undress waist upwards.
• If you have undergone breast implant surgery, any previous breast surgery, chemoport insertion or pacemaker, please inform the technician when you come to the mammography room
• Avoid wearing perfume, lotion, powder or deodorant on your breasts and underarms as it may affect image quality.
• Fall risk assessment:
• If you have any prior history of vertigo, giddiness, vasovagal attacks, difficulty in standing, please inform the technician in the mammogram room.
• You will be asked to sign a consent form which states that you agree to undergo the test and understand what it involves.

• What happens during the procedure?
• Pressure may be felt as each breast will be squeezed by the compression paddle. Women with sensitive breasts may experience some discomfort, please inform the technologist. During tomosynthesis, the tube rotates in an arc-like fashion, your face and other body parts must remain away from the tube to avoid artefacts.

• What happens after I undergo the mammogram?
• The images will be read by a radiologist and sometimes a call back is necessary to further evaluate an area of concern. Though it may seem alarming, many women are called back to help in preparing the most accurate report. If the radiologist spots a potential area of concern, you may be asked to return for additional diagnostic mammogram images or ultrasound.

• After the procedure:
• No special instructions need to be followed, one can pursue normal activities.

• What are the limitations of mammography?
• Dense breast tissue makes it difficult to see a cancer on mammography. In such scenarios, a sonomammogram (breast ultrasound) may be suggested for additional evaluation. Breast implants may block a clear view of tissues underneath and it is advisable to inform the technologist prior to the test.

• SONOMAMMOGRAM & ELASTOGRAPHY:
• Sonomammogram or breast ultrasound is performed using a high-frequency linear transducer, as a solitary test, if performed under the age of 40 years or coupled with mammography for diagnostic indications. It is a safe examination as sonography does not involve radiation. Breast ultrasound elastography is an advanced tool that uses strain or shear-wave technology for quantification of tissue stiffness. It helps in further clarification of breast lesions to improve sensitivity and specificity of diagnosis.

• MRI BREAST:
• MRI Breast is performed at RFH on state-of-the-art 3T MRI with dedicated breast coil typically performed for certain indications like women with high risk or dense breasts. MRI breast is not better than mammography, just different. Examination takes about 45 minutes and nearly always involves a contrast injection. A prescription from your referring doctor will be required prior to making an appointment.

• BREAST INTERVENTIONS:
• Various interventional procedures namely breast lump core biopsy, cyst and abscess aspiration and hook-wire placements are performed under high-frequency ultrasound guidance to improve accuracy of obtaining sample for assessment. Additionally, a suspicious area seen only on MRI can be targeted using our specialized MRI guided biopsy equipment. A prescription from your referring doctor will be required prior to making an appointment for these services.