DIAGNOSTIC RADIOLOGY

Our non-invasive imaging methodologies are used to diagnose and manage your health while providing therapeutic options and expert advice.

IMAGING SERVICES

computed tomography (CT)


What it is: A CT (computed tomography) scan uses a narrow beam of X-rays and computer processing to generate 2D and 3D images of body structures. A CT is quick and non-invasive and sometimes a good alternative for patients who cannot have an MRI. Contrast dye may be injected into the veins or oral contrast solution may be given in certain cases to highlight different tissues for diagnosis.


What to expect: You will lie on a table and feel it move after each scan. The technologist will instruct you when to hold still or hold your breath. An IV will be placed into your vein beforehand if contrast is being injected. The time to scan may only be a few minutes, but the time spent in the room may be 10-15 minutes.


CT scan uses: Head to toe imaging (Head, Neck, Spine, Chest, Abdomen, Pelvis, Extremities)

Examples of Advanced uses for CT

Imaging of pain or complication after artificial joint surgery

The metal in a total joint replacement often causes problems for conventional CT and MRI scans. Dual-energy technique is utilized to reduce metallic artifact to see tissues around the prosthesis otherwise obscured.


Contact: Dr. Brian Yue (byue@laiic.com) 

Chronic back pain after complex spinal surgery

Many factors can contribute to diffuse, dull, aching pain or nerve pain also known as “failed back syndrome”. 


A non-invasive CT with metallic artifact reduction or a CT myelogram procedure may help diagnose abnormal bone healing, implant loosening, or scar tissue to further guide pain management and surgical treatment.


Contact: Dr. Brian Yue (byue@laiic.com) 

Head-to-toe CT angiography to detect aneurysm, narrowing, blockage, or vascular damage

See more at Interventional Radiology


Non-invasive 3D imaging of blood vessel disease can uncover treatable causes of headache, neck pain, hand and foot pain, cramping, and other problems with blood circulation


Contact Dr. Sabeen Dhand (sdhand@laiic.com) and Dr. Paul O’Connor (poconnor@laiic.com) 


Calcium scoring and coronary CT angiogram for heart disease 

A specialized scan to measure the amount of calcified plaque in the arteries before the signs and symptoms of coronary artery disease. This may help determine lifestyle management or medical treatment to reduce risk of heart attack or other problems. 


A coronary CTA uses a contrast injection to determine narrowing of the arteries or other vascular problems in 3D.


Contact Dr. Daniel Saket (dsaket@laiic.com ) 

Low dose lung cancer screening

PIH Whittier is a designated ACR Lung Cancer Screening Center


https://www.acraccreditation.org/Lung-Cancer-Screening-Center


https://www.acr.org/Media-Center/ACR-News-Releases/2020/Updated-USPSTF-Lung-Cancer-Screening-Guidelines-Would-Help-Save-Lives


Annual lung cancer screening with low-dose computed tomography (LDCT) in high-risk patients significantly reduces lung cancer deaths. This screening can identify cancers at an early, treatable and curable stage. Given that the American Cancer Society predicts 135,720 lung cancer deaths this year, more-widespread screening could save 30,000–60,000 lives in the United States each year.

Contact Dr. Nanette Kovash (nkovash@laiic.com)

Dual energy non-invasive test for gout

A dual energy CT is a specialized examination that may help your rheumatologist or primary care physician diagnose gout or conditions mimicking gout and guide treatment and management of symptoms.


Contact: Dr. Brian Yue (byue@laiic.com)

Rapid diagnosis and management for acute stroke

PIH Whittier holds Comprehensive Stroke Center Certification by The Joint Commission and AHA/ASA.


PIH Downey meets standards for Primary Stroke Center


Contact: Dr. Shao-Pow Lin (slin@laiic.com) 

CT-guidance for biopsies, drainages, pain management, and cancer treatment

Utilize CT imaging to guide minimally invasive, less painful procedures that would otherwise require much larger surgery, such as:

 

Biopsy for diagnosis of cancer or infection

Abscess drainage

Celiac plexus block

Localization for surgery

Microwave ablation for liver cancer

Microwave or cryoablation for renal cancer

 

Contact: Dr. Joseph Park (jpark@laiic.com) 



Magnetic Resonance IMAGING (MRI)


What it is:  Also known as Magnetic Resonance Imaging, an MRI scan uses a powerful magnet, radio waves, and computer processing to generate 2D and 3D images of select body parts. MRIs are non-invasive and avoid X-ray radiation exposure. As part of the examination, contrast may be injected into the veins to improve the image and quality of the study.

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What to expect: You will lay on a table and will be required to lie still during the MR scan. Depending on the body part that is being examined, you may be instructed to hold your breath for up to 30 seconds. The part of the body being scanned will be placed in the middle of the magnet. During imaging, you will hear a loud intermittent banging noise. You will be provided with earplugs to minimize the noise during the procedure. The technologist will provide you with an alarm button to alert the technologist of any discomfort you may experience at any point during the MRI exam. An IV will be placed into your vein beforehand if contrast is being injected. 


MR Scan Uses: Head to toe imaging (Head, Neck, Spine, Chest, Abdomen, Pelvis, Extremities, Blood Vessels)

EXAMPLES OF ADVANCED USES FOR MRI
 

Neurological

  • Stroke
  • Trauma
  • Tumors
  • Cysts
  • Developmental and Structural abnormalities
  • Infections
  • Inflammatory Conditions
  • Blood Vessels

Body

  • Liver
  • Gallbladder
  • Bile Ducts
  • Pancreas
  • Adrenal Glands
  • Kidneys
  • Rectum
  • Uterus/Ovaries
  • Genitalia

Musculoskeletal

  • Temporomandibular joints
  • Chest wall
  • Pelvis, sacrum, coccyx
  • Hip, thigh, knee, calf, ankle, foot, toes
  • Shoulder, arm, elbow, forearm, wrist, hand, fingers

Cardiac

  • Coronary artery disease
  • Cardiac masses and thrombi
  • Pericardium
  • Cardiomyopathy
  • Congenital cardiac disease
  • Arrhythmia
  • Aortic and valvular disease

Enterography 

Provides detailed pictures of your small intestine. It can pinpoint:

  • Inflammation
  • Bleeding
  • Masses
  • Fistula
  • Other conditions

Prostate

  • Noninvasive and pain free
  • Help guide biopsies and avoid unnecessary biopsies
  • Determine how advanced cancer is and whether it has spread
  • Detect other prostate conditions


ULTRASOUND (US)


What it is: Ultrasound scanning uses high-frequency sound waves to produce images of structures and organs in the body. Ultrasound produces excellent images of organs that are soft and/or fluid filled. The images can provide valuable information for diagnosing and treating a variety of diseases and conditions. Also known as a sonogram, an Ultrasound uses high-frequency sound waves applied through a transducer delivered into body tissues to create echoes which are decoded into real-time images on a computer screen. There is no X-ray radiation exposure.

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What to expect: The exam will be performed in a special hospital or clinic suite. You will be asked to remove clothing and jewelry from the area being scanned. You will be given a hospital gown and will be asked to sit or lie down on an examination table. A small amount of gel will be applied on your skin over the area to be scanned to help transmit the sound waves into your body. The sonographer will slide a transducer through this gel to send sound waves into your body and receive reflected sound waves to create pictures of your organs. Most exams take 15 - 30 minutes to complete. The procedure is safe and generally painless. 


US Scan Uses: Study a developing fetus, abdominal and pelvic organs, muscles and tendons, or blood vessels and guide needle biopsies and drainages.

Examples of Advanced Uses for Ultrasound

Abdomen

  • Abdominal, flank, or back pain
  • Mass or swelling
  • Fluid accumulation or hematoma evaluation
  • Urinary symptoms
  • Gallbladder disease
  • Appendicitis

Liver

  • Cirrhosis
  • Fatty liver
  • Abnormal bile ducts
  • Search for mass or metastatic disease
  • Check vascular flow to monitor cirrhosis or pre-transplant workup

Kidney

  • Abnormal renal function
  • Hydronephrosis or other urine blockage
  • Hypertension
  • Transplant evaluation

Pelvis

  • Pelvic pain or mass
  • Abnormalities of uterus and ovaries
  • Painful or heavy menses
  • Postmenopausal bleeding
  • Intrauterine device localization

Pregnant Uterus

  • Evaluation of fetal growth and anatomy
  • Estimate gestational age of pregnancy
  • Ectopic pregnancy
  • Abnormal pain or bleeding

Soft Tissue

  • Mass
  • Fluid collection
  • Lymph node enlargement

Scrotum and Testis

  • Pain
  • Mass
  • Swelling
  • Hernia or varicocele evaluation

Head and Neck

  • Salivary gland mass
  • Lymph node enlargement
  • Other neck masses
  • Thyroid enlargement or nodules
  • Monitoring after cancer treatment

Vascular

  • Check function and evaluate abnormal narrowing or dilation of the carotid arteries or other vessels to the arms and legs
  • Evaluate blood clots to the arms and legs
  • Evaluate varicose veins for potential therapy

Biopsies

  • Thyroid
  • Parotid
  • Liver
  • Kidney
  • Soft tissue

Sonohysterogram

  • Uterine cavity mass or thickening
  • Abnormal bleeding

Pediatric 

  • Hip dysplasia or click
  • Developmental spinal cord abnormalities
  • Hypertrophic pyloric stenosis
  • Intussusception
  • Mass or swelling

Musculoskeletal 

  • Steroid injection
  • Joint effusion and aspiration
  • Rheumatoid arthritis synovitis screening and synovial biopsy
  • Achilles tendonitis
  • Plantar fasciitis
  • Rotator cuff or other bone, tendon, or ligament injury or pathology
  • Ganglion cyst or other soft tissue mass or swelling


NUCLEAR MEDICINE (NM)


What it is: There are many types of nuclear medicine scan, but all of them involve the application of radioactive material into the body followed by a scan. The radiation emitted from within the body will be recorded by a camera detector which will generate the image. Valuable information about body physiology and function can be obtained.

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What to expect: You will be given the radiopharmaceutical orally or by injection. You will lay underneath a camera for a period of time as the images are acquired. Depending on the type of exam, the image collection may occur immediately or at certain time intervals sometimes for a few minutes while for certain other scans you may be asked to return after several hours or even the next day or two to complete the examination. You will be instructed on how to properly minimize radiation exposure to others and yourself following the scan (e.g. maintain distance, drink fluids, etc).


NM Scan Uses: To study normal or abnormal function of various body organ systems. To monitor or detect tumor or infection.

Examples of ADVANCED USES FOR NUCLEAR MEDICINE

Bone Scan

Used to identify fracture, orthopedic hardware loosening or infection, tumor, or other inflammation

Myocardial Perfusion Scan

Used to detect scarring or at-risk cardiac tissue for myocardial infarction

Blood Cell Imaging

Used to label white blood cells to find infectious and inflammatory processes in the body

Hepatobiliary Scan

  • Complications of gallstones and common bile duct stones
  • Liver function
  • Bile leak

Thyroid Scan

  • Evaluate benign and malignant thyroid nodules. 
  • Measure thyroid uptake and function
  • Evaluate hyperthyroidism and hypothyroidism

Renal Scan

  • Evaluate kidney function 
  • Assess severity and cause of urinary obstruction

Gastrointestinal Imaging

  • Localize active gastrointestinal bleeding
  • Evaluate gastroparesis and assess delayed gastric emptying

Lung Scan 

  • Quantify lung ventilation and blood flow
  • Detect likelihood of blood clots in the pulmonary arteries

PET/CT Scan

  • Utilizes the glucose analog FDG to diagnose, stage, and monitor therapy for many types of cancer
  • Search for metastatic disease or a primary cancer
  • Non-invasive evaluation of a solitary pulmonary nodule

Radioiodine Therapy

  • Definitive treatment of hyperthyroidism (such as Grave’s disease)
  • Thyroid cancer treatment monitoring

FLUOROSCOPY AND RADIOGRAPHY (X-RAY)

What it is: Fluoroscopy is a type of medical imaging that shows a continuous X-ray image on a monitor, much like an X-ray movie. Digital Radiography is the newest replacement of conventional X-ray film radiography and offers the advantages of decreased radiation dose and shortened imaging time.


What to Expect: The amount of radiation is very low. You may be asked to stand or lie down during the examination depending on what is needed. Some fluoroscopy procedures may require the administration of contrast material.


X-Ray Scan Uses: Radiography is the most economical way to evaluate the bones and lungs. It may also be used to evaluate musculoskeletal injuries, cancer, abdominal pain, and back pain. Fluoroscopy can evaluate function in addition to anatomy with the additional information provided by real-time movie images, often enhanced by the use of contrast.

Examples of Advanced USES FOR FLUOROSCOPY AND RADIOGRAPHY

Abdominal Radiography

Abdominal pain, bloating, or kidney stones

Video Swallow 

Contrast is given orally to diagnose problems of the oropharynx and upper esophagus relating to swallowing. It is sometimes performed with the supervision of a speech pathologist.

Esophagram

Contrast is given orally primarily to diagnose problems of the lower esophagus such as acid reflux, regurgitation, regurgitation, hiatal hernia, feeling of a lump in the throat or chest (globus sensation)

Upper Gastrointestinal Series 

Contrast is given orally to diagnose problems with the stomach and duodenum (upper small intestine) such as peptic ulcer disease, reflux, or pain when eating

Small Bowel Series

Contrast is given orally to evaluate the anatomy and function of the small intestine

Colonography

Sometimes also known as a “barium enema”, contrast is given through the rectum to evaluate for a mass or stricture in the colon, as an adjunct to colonoscopy

Abscessogram / Fistulogram

Contrast is injected through a preexisting opening or draining site in the skin to detect any communication with deeper structures

Retrograde Urethrogram

Contrast is injected through a catheter to evaluate the penile urethra and bladder

Voiding Cystourethrogram

Contrast is injected through a bladder catheter to evaluate the bladder function and detect abnormal urine reflux into the kidneys

Musculoskeletal

  • Steroid injections into joints and tendon sheaths for arthritis and inflammation pain control
  • Contrast injection into joints prior to specialized MRI exams