What's New In Radiology
Monday April 3, 2000
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Linda Strangio, RN, nursing coordinator, Mountainside Hospital, Montclair, NJ, says there are many rew radiology procedures that reduce patient risk during the diagnostic phase of treatment.
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The examination is performed using a helical CT scanner. Scanning time itself is less than a minute and uses the same amount
of radiation as a standard chest x-ray. Intravenous contrast material is not needed and the patient needs no prep. Most insurance plans do not yet cover the test, but the potential to save lives may be worth the cost to many people.
Heart Attack Prevention
A new device has been developed that measures blockage of the coronary arteries by quantifying the amount of calcium in the walls of the vessels. Calcifications of the vessel wall are always an indication of arteriosclerosis, but these calcifications often go unnoticed until the patient presents with chest pain. Now there is a simple test to identify potentially life- threatening conditions before they cause symptoms.
Using super-fast cardiac spiral CT scan technology, coronary artery calcium-scoring software allows sub-second imaging of coronary vessels. The ECG-triggered images are acquired only during the patient's diastolic phase to ensure clear images that are free of motion artifacts. The test is completely painless, noninvasive, and typically takes about 10 minutes. This exam also is not yet reimbursed by insurance, and the cost is approximately $500.
Sentinel Node Biopsy
Women with positive breast biopsies routinely undergo lymph node dissection to help determine the extent of node metastasis. Many women suffer from symptoms such as lymphadema and pain as a result of this procedure.
A relatively new technique may now be offered to some women that can spare them the untoward effects of axillary node dissection. In the nuclear medicine department, four small subcutaneous injections are given around the breast lesion. The mildly radioactive agent given is Technetium-99m-Colloidal Albumin. This agent, like normal body fluid, drains from the breast and goes through the lymph channels, but since it is radioactive, it can be tracked. The patient goes to the operating room and the nodes are tracked with a gamma probe, which is a type of geiger counter. The first node in which the radioisotope can be found is then identified as the "sentinel" or first node into which the breast empties. That node is then removed and sent to pathology. If it comes back negative, many surgeons believe that the cancer has not spread beyond the breast; the theory is that if the sentinel node is clean, so must be the next nodes in that chain.
Avoiding Lung Biopsy
Another nuclear medicine procedure has the potential to point toward a pathological diagnosis of lung lesions, replacing the need for invasive lung biopsies. This procedure may be used in patients with pulmonary masses that are highly suspected to be malignant.
In a Neotect Scan, the agent Technetium Tc 99 Depreotide is injected intravenously, and the patient is scanned three hours later. A positive scan strongly suggests that the patient has lung cancer as opposed to having some type of benign lesion. The patient then may be quickly scheduled for a thoracotomy, without having to lose valuable time and undergo risks associated with lung biopsy. Neotect Scans are covered by most insurance plans.
For more information about these exams or any other radiological procedures, contact Linda Strangio, RN, at (973) 429-6233.
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