• Frequently Asked Questions

  • Why is it often necessary to have an x-ray of a bone or joint when an MRI is ordered?

    X-rays and MRI are very different.  While MRI demonstrates tendons, ligaments, cartilage, and soft tissues well,  it can miss things like small loose bodies in joints, calcification in soft tissues and cartilage, and gas in tissues.  X-ray is excellent in detecting these abnormalities.  When dealing with tumors, MRI demonstrates the full extent of the abnormality, but the diagnosis is usually made by looking at an x-ray. When the two modalities are used in a complementary fashion, little is missed and a confident diagnosis can usually be made.


    Why is it necessary to drink oral contrast for some studies, like CT scans of the abdomen and pelvis?

    Some hospitals do not require patients to drink oral contrast, believing that getting the exam done faster is more important than finding every abnormality.  However, having contrast inside the stomach and intestines allows the radiologist to see tumors, ulcers, diverticula, and inflammation which would otherwise not be visible.   Without oral contrast, a wide range of diagnoses can avoid detection, ranging from chronic life-changing diseases like inflammatory bowel disease to deadly conditions like cancer.  We believe every patient deserves the most accurate examination possible.  The relatively small amount of time spent drinking oral contrast is well worth the added diagnostic sensitivity.  


    Why do some sources recommend beginning screening mammography at age 40 and others at age 50?

    Research has shown than, on average, breast cancers can be found on mammograms about 1.7 years before being detectable on clinical exam.

    The guidelines to start annual breast cancer screening at age 40 are agreed upon by the American College of Radiology, the American Cancer Society, the American College of Obstretrics and Gynecology, and the American College of Surgeons.  Every woman should start annual screening mammography at age 40. If she has a mother or sister who had breast cancer diagnosed before age 50, she  should start sooner, usually ten years younger than the age at which her relative was diagnosed, but not before the age of 25.  Breast cancers in women under 50 are usually more aggressive, making early diagnosis crucial.   The recommendation to begin mammography at age 50 came from the United States Preventative Services Task Force. This has been widely discussed, and most breast cancer experts believe the task force conclusions were based on a flawed data analysis.


    What differentiates a screening mammogram from a diagnostic mammogram? Aren't they both just mammograms?

    A screening mammogram consists of standardized views of the breasts to look for evidence of early breast cancer. These are only performed on women for whom neither breast has changed. Worrisome changes on screening mammogram trigger a separate diagnostic mammogram.

    A diagnostic mammogram is supervised by a radiologist. Any breast change, such as a new lump, nipple discharge, nipple retraction, pain, or new abnormality on screening mammogram, is an indication to perform diagnostic mammography. The test may consist of angled views, magnification views, compression views, and various custom views. The exam takes longer than a screening mammogram and isn't over until the radiologist is satisfied. The goal is separating possible cancers from benign changes.

    An ultrasound of the breast may be done with a diagnostic mammogram if the radiologist feels this will improve the accuracy of the diagnosis.


    What on-site services are offered at the rural hospitals we serve?

    These hospitals are located in Algona, Britt, Osage, Cresco, Hampton, New Hampton, Emmetsberg, Clarion, Belmond, and Iowa Falls. We travel to each facility one or two days per week to provide breast ultrasound, diagnostic mammography, flouroscopy studies of the throat, esophagus, stomach, small bowel, and colon, and image-guided procedures such as shoulder and hip injections. When not on-site, we supervise and interpret radiology studies performed in these hospitals seven days per week utilizing remote teleradiology.


    What is 3-D mammography?

    3-D mammography, or tomosynthesis, is a relatively new way to image the breast. A conventional mammogram images the entire breast in one picture, with all the tissues in the breast overlapping. A 3-D mammogram images the breast in much thinner slices, allowing the separation of overlapping tissues. This helps us detect otherwise hidden cancers and decreases false positives caused by overlapping normal tissue. The radiation dose is the same as a normal mammogram, which is very low.


    How Much Radiation Do I Get From a Mammogram?

    The total radiation dose for an entire mammography study, consisting of two pictures of each breast, is about 0.4 mSv. For comparison, this is about as much as the average person gets from natural sources like solar radiation and ground radiation (mostly radon) in about 5-7 weeks of everyday activities.

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