Imaging Services (Radiology/Nuclear Medicine)
Our Services
The Dana Farber/Brigham and Women's Cancer Center Radiology Department offers the following imaging services for cancer patients:
On this page
- CT Scan
- Magnetic Resonance Imaging (MRI)
- Nuclear Medicine (including PET)
- Diagnostic X-rays
- Ultrasound
- Breast Imaging and Diagnosis (including Mammography)
- Interventional Radiology
CT Scan (Computed Tomography, also known as CAT scan or Computed Axial Tomography)
Unlike a conventional x-ray, computed tomography, commonly called CT scanning, captures a series of images called slices that show a slim cross-section of the area of interest. A study is made up of many slices of a body area, such as the head or abdomen. Because the images produced are cross-sections, they reveal information about the insides of organs and tissues, something a conventional x-ray cannot do.
If you are scheduled to receive a CT scan, you should not eat solid food for four hours prior to your appointment. You may, however, have clear liquids in moderate amounts. You may also be asked to remove jewelry or other metal objects and change into a hospital gown. Depending on the area of interest, you may be asked to ingest or receive an injection of a contrast agent. This agent will help particular structures, such as the intestines or blood vessels, show up more clearly on the images.
The technologist will position you on a table attached to the doughnut-shaped CT machine. Once you are in position, the technologist will leave the room and monitor the exam from an adjacent control room. You can maintain contact with the technologist via an intercom. The table will slide into position so that the "doughnut" surrounds you. While the images are being taken, you will be asked to hold your breath. The table will move slightly as the inner ring of the machine spins around you. You will not be able to see or feel the x-rays as they pass through your body, but it is normal to hear the "spinning" noises produced by the machine as it moves.
The length of time required for a CT examination—including the administration of contrast, positioning, and imaging—varies according to the type of study requested by your physician. After the exam, you can resume your normal activities without restriction. A radiologist will review and interpret the images, and the report will be sent to the referring physician.
Magnetic Resonance Imaging (MRI)
Magnetic resonance imaging creates a remarkably clear picture of both bone and soft tissue using a strong magnetic field. Like CT scanning, MRI provides a series of cross-sectional images of the anatomy. MRI, however, accomplishes this task without radiation and is capable of producing highly detailed images of soft tissues, such as the muscles, blood vessels, brain, and other organs.
To prepare for the examination, you should take off all jewelry, as well as hairpins, eyeglasses, hearing aids, and removable dental appliances. In the examination room, the technologist will position you on the table attached to the doughnut-shaped MRI machine. Depending on the type of examination, the technologist may insert an intravenous catheter for the administration of contrast material during the course of the exam. This material helps certain organs and tissues show up more clearly.
Once you are in position, the technologist will leave the room and monitor the exam from an adjacent control room. You will remain in voice contact with the technologist through the intercom. The table will slide into position so that the "doughnut" surrounds you. While the images are being taken, you will be asked to remain still. The table will move slightly as the inner ring of the machine spins around you. It is not abnormal to feel a warm sensation in the area being examined, or to feel a cool sensation at the catheter site when contrast material is injected. The machine does produce loud tapping noises during some phases of imaging; you may wish to use earplugs, which the technologist can provide.
The length of time required for a MRI examination—including the administration of contrast, positioning, and imaging—varies according to the type of study requested by your physician, but the average is about 45 minutes. After the exam, you can resume your normal activities without restriction. A radiologist will review and interpret the images, and the report will be sent to the referring physician.
Nuclear Medicine (including PET)
Nuclear medicine imaging provides your physician with images of your body that illustrate how your organs and tissues are working. These images can be used to diagnose and monitor diseases that affect almost every major system of the body. Each specific type of examination is different, but there are a few common characteristics. In each type of study, a material called a radiotracer is injected in a vein or ingested.
Different tracers are used for different studies, but each is formulated to be attracted to particular cells and organ systems. The radiotracer is absorbed by the target cells, which can then be imaged with a gamma or positron camera. Nuclear medicine physicians can interpret the images and determine whether or not the cells are behaving normally based on the concentration of the radiotracer. In some studies, images are taken at multiple time points, enabling the evaluation of organ function over time.
The most significant benefit of nuclear medicine is that these non-invasive studies provide information that might only otherwise be obtained through surgery. Nuclear medicine imaging is safer and more cost-effective than surgery, and requires no recovery; you can resume normal activities as soon as the study is complete. For many studies, no special preparation is required. For some, however, you may be asked to avoid eating solid foods for several hours before the examination. Your doctor will discuss such details with you.
Nuclear Medicine's state-of-the-art facility houses a fully digitized network of four multi-head gamma camera systems and a high-end full ring PET Scanner. Other services include a wide range of diagnostic and therapeutic procedures. Specialized nuclear medicine diagnostic approaches and therapeutic techniques are continuously developed and implemented to meet the needs of patients enrolled in numerous cancer treatment protocols. Therapies offered include alleviation of bone pain in patients with skeletal metastases using unsealed radioactive sources, and treatment of lymphoma using radiolabeled antibodies.
Nuclear medicine studies performed at Dana-Farber/Brigham and Women's Cancer Center include:
- Bone Scan
- Flow Study
- Gallium Scan
- Hepatobiliary Scan
- Lymphoscintigram
- Oncoscint. Scan
- Renal Scan
- RVG
- Somatostatin Receptor Imaging Scan
- CEA-SCAN.
- Thallium scan
- Prostascint. Scan
- Strontium-89 Therapy (Metastron.)/Samarium -153 Therapy (Quadramet.)
Diagnostic X-rays
Radiography is the oldest form of medical imaging, and it is still the most frequently used. This technique produces an image of the shadows cast by your organs and tissues. Tissues that are denser, such as bones or blood vessels infused with contrast agents, are more clearly visible than other tissues.
There is no special preparation for a standard x-ray, though you will be asked to remove any jewelry or other metal in the area of interest, and may need to change into a hospital gown. The technologist will help you get into the correct position for your exam and will talk you through the procedure. As each image is taken, you will be asked to remain very still—even hold your breath—for a few seconds. You cannot see or feel the x-rays passing through your body; it is a painless procedure. A standard x-ray examination lasts 10-15 minutes per area of interest, during which time several images are taken.
Diagnostic radiology provides a specialized type of radiography called fluoroscopy. Fluoroscopy uses x-rays to produce a real-time, moving image. A contrast agent is used so that specific structures (such as the intestines or blood vessels) will show up clearly during the exam. Depending on the exam, your doctor should discuss with you any special preparations you will need to follow. You will be asked to change into a hospital gown. The technologist will get you into position and provide instructions throughout the procedure. As he or she observes the moving images, still frames can be captured to illustrate regions and functions of interest.
Regardless of which site you visit, a radiologist will review and interpret the images, and the report will be sent to the referring physician.
Ultrasound (also called sonography or ultrasonography)
Ultrasound is a type of imaging study based on the energy of sound waves. High-frequency sound waves—far above the audible range—are directed toward the area of interest. Different tissues reflect, absorb, and refract the waves differently, and the echoes are transformed into a real-time image.
Preparations for an ultrasound examination depend on the type of exam scheduled. Your doctor should discuss the preparations with you. You may or may not be asked to change into a hospital gown, depending on the type of exam. For most studies, the technologist will apply a gel to the skin over the area of interest. He or she will then press the transducer—the handheld piece of equipment that produces and receives high frequency sound waves—firmly against the skin (this may cause slight discomfort) and an image will appear on the monitor. A series of still images will be captured on film. In some cases, a much smaller transducer—called a probe—will be inserted into a body cavity in order to obtain the required images. The use of sound waves for imaging is completely painless and without side effects.
After the exam, you can resume your normal activities without restriction. A radiologist will review and interpret the images, and the report will be sent to the referring physician. You can expect to receive your results from your physician within approximately 48 hours.
Breast Imaging and Diagnosis (including Mammography)
Mammography is a specialized form of x-ray that is used to detect and monitor changes in the breast tissue. On the day that your exam in scheduled, you should avoid using lotions, creams, powders, perfumes, and anti-perspirant/deodorant products near your breasts (including the underarms), or plan to wash them off prior to the exam. These items may contain ingredients that could interfere with the exam. No other special preparation is necessary. When you arrive for your appointment, you will be given a hospital gown and asked to remove all clothing form the waist up. You will also be asked to remove any jewelry or metal that could interfere with the exam.
A registered technologist with special training in mammography will position you for each image. In a typical exam, two images are taken of each breast. The breast will be positioned between two plates. Just before each image is taken, the plates will compress the breast slightly. Although this is often uncomfortable, it should not be painful. Compression is necessary to get a clear image of the breast tissue.
The actual imaging takes just a few seconds, but the whole procedure lasts 5-10 minutes. You will be asked to wait while the radiologist studies your images. As the board-certified radiologist reviews your films, he or she may request that additional images be taken or that a sonogram be performed in order to fully evaluate your results. After the examination, the radiologist will meet with you to discuss your results and will give you a written report. Your results will also be sent to your physician.
Another procedure available within the Breast Imaging Service is large-core breast biopsy. In this procedure, a small tissue sample (a "core" of tissue) is removed with a needle from an apparent abnormality in the breast. No surgical incision is required and only local anesthetic is needed. Specially-designed mammography equipment is used to provide guidance during the procedure to ensure that tissue samples are collected from an appropriate location. After the procedure, the patient can return to normal activities. It is not uncommon for the patient to develop a small bruise over the area. Results of the biopsy are provided to the referring physician. If the referring physician requests it, the results will also be provided directly to the patient. Many patients who have undergone previous surgical biopsy are very enthusiastic about this alternative procedure. Large-core breast biopsy is performed at the Breast Imaging and Diagnostic Center.
Our mammographers are all board certified in radiology and are certified by the American College of Radiology in Mammography. Mammographic interpretation is performed at the time of each study with a written final report given to each patient by the interpreting radiologist.
Ultrasound-guided core biopsy of breast tumors is performed by Jack Meyer, MD, one of the world's leading experts in this procedure.
Interventional Radiology
Interventional radiology covers a group of procedures preformed with the guidance of various imaging techniques. Image-guided procedures are used for both diagnostic and therapeutic purposes, and include tissue and tumor biopsy, needle aspiration of fluid collections, catheter drainage of fluid, cyst puncture and analyses, and ablation (tissue destruction) therapies.
You should not eat or drink (aside from a small amount of water with your daily medications) for at least six hours (12 hours, preferably) prior to your appointment. When you arrive, you will be asked to change into a hospital gown. For most procedures, an intravenous catheter will be placed in your arm in order to provide fluids and medications during the procedure. Your blood pressure will be taken, and you will be fitted with probes to monitor your blood oxygen level (clipped to your finger) and your heart rate (taped to your chest). You will be given local anesthesia, but you will be awake during the procedure because you must be able to follow breathing instructions. Procedures typically last 30-90 minutes, though some take longer.
When your interventional procedure is complete, you will be moved to a recovery room for observation. A radiologist will speak with you about specific home-care instructions before you leave the hospital. The results of your procedure will be reported to your referring physician.
