Then & Now

Better Diagnosis & Treatment

By revealing how the body works, advanced imaging modalities can fill gaps in medical knowledge and enhance patient care through improved diagnosis and treatment.

Examples

The third leading cause of cancer deaths in the United States, colorectal cancer claims some 50,000 lives annually. While standard colonoscopy can detect polyps and tumors early, some people are justifiably nervous about the procedure. Computed tomographic colonography (CTC), or “virtual colonoscopy,” uses a low-dose CT scan to spot polyps and tumors in the colon and is faster to perform than colonoscopy. Because sedation is not required, there is minimal recovery time and patients do not need a companion to drive them home—all of which may help increase patient compliance and in turn detect cancer earlier. A study from the National Naval Medical Center/Walter Reed Army Medical Center found that, when given the option, 40% of patients choose to undergo virtual colonoscopy, and 37% of those who had colon screening said that would not have done so without virtual colonoscopy.

Positron emission tomography (PET) imaging is highly targeted, using small amounts of radiotracers to show how tissues function. PET imaging can identify where malignant cancers have spread in the body and monitor the effectiveness of chemotherapy. Additionally, by identifying less aggressive cancers, this powerful combination approach can help better target treatment. Studies have shown PET to be effective in staging certain types of lung cancer, Hodgkin’s lymphoma and colorectal cancer, and determining if cancer cells have spread to lymph nodes—all without lifting a scalpel.

Transferring injured patients from the emergency room to radiology for needed imaging services can slow diagnosis and treatment. Now, a portable device called C-Arm fluoroscope helps cut treatment time in half, which is especially valuable in emergency and trauma medicine. The C-Arm provides live guidance to insert tubes, catheters, plates and stents that are used to keep airways open and arteries flowing. It can also take images of broken bones, even if the patient is unable to remain still.

Imaging advances have opened the door to improved testing and treatment for heart disease, the number one killer of Americans. Cardiac computed tomography angiography (CCTA) provides a highly accurate image of the heart vessels to determine if low-risk chest pain patients need care or can be discharged from the emergency department and avoid costly, invasive surgery. Positron emission tomography (PET) helps doctors diagnose coronary artery disease (CAD), assess damage from a heart attack and determine whether a patient will benefit from a surgical intervention. Cardiovascular magnetic resonance (CMR) can help aid in the detection and differential diagnosis of acute coronary syndromes (ACS) from other acute myocardial diseases and help determine prognosis. Interventional X-ray allows for the use of a balloon -expandable stent to treat blocked coronary arteries.

Positron emission mammography can spot cancers about the width of a grain of rice.

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