Untitled - Jerudong Park Medical Centre

MRI 3 

Cardiac MRI 7 

Breast MRI 12 

Multi-Slice (64-slice) CT 16 

Scanning Peripheral QCT 24 

Mammogram (Breast X-ray) 29 

Ultrasound 33

Your doctor has chosen Jerudong Park Medical 

Centre (JPMC) for your radiology procedure. JPMC 

has earned a regional reputation for quality and 

excellence in providing superb diagnostic imaging 

and diagnostic imaging services, thoughtful patient 

care, and radiological interpretations that are second 

to none. Rest assured that when you come to JPMC 

for your radiology examination, you are in the best of 

hands. 

At JPMC, we use only state-of-the-art imaging 

equipment managed by highly experienced 

technologists and radiologist. This is to ensure the 

highest quality images, which allow our radiologist to 

make accurate diagnoses so that you will receive the 

most effective treatment. 

The Diagnostic Imaging Department (Radiology) 

at Jerudong Park Medical Centre, is one of the most 

modern imaging departments in Southeast Asia. 

CT Scan 

Digital X-Ray 

Services are supported by a versatile general 

radiographic suite with Digital CR and a 

64-slice CT scanner. The CT scanner with cardial 

& angiography CT capabilities 

provides state-of-the-art imaging 

in this modality. 

For sophisticated neuroradiological 

and musculoskeletal 

examinations, there 

is a 1.5 Tesla superconducting 

MRI system with cardiac MRI, 

Breast MRI & MR Angiography 

capability. 

MRI 

Radiology Diagnostic Imaging Services • 1

Ultrasound 

Dental X Ray system 

The Ultrasound section of the Diagnostic 

Imaging Department boasts of the latest high-end 

Ultrasound machines with intracavitory probes 

and Color Doppler features. This allows the use of 

Sonography in a wide spectrum of conditions. 

A sophisticated film-screen mammography system 

and high-resolution Ultrasound system provide 

modern breast imaging and advanced precision 

biopsy capabilities. 

Mammography 

Fluoroscopy 

Conventional gastro-intestinal studies and other 

procedures which require fluoroscopic control are 

carried out in a digital fluoroscopy suite with 

sophisticated image storage and post processing 

facilities. 

An additional general radiography suite is available 

for routine investigations including conventional 

Tomographic studies. 

This modern and well-equipped department 

consists of an experienced team of a Specialist 

Radiologist and 6 Technologist. The Radiologist and 

his team perform a broad spectrum of procedures 

and are multi-skilled with individualised areas of 

specialisation. 

2 • Radiology Diagnostic Imaging Services

What is MRI 

MRI, otherwise also called Magnetic Resonance 

Imaging, allows us to see very clearly inside the 

human body without the use of X-rays. MRI images 

help us to make the best possible diagnosis. 

How does it work 

MRI produces clear internal body images by using 

a particular radio frequency to create momentary 

magnetic changes. A computer then analyses the 

signals returned by various tissues. 

Is there any risk 

There is no risk to the average patient who follows 

appropriate guidelines regarding metallic items 

within the body. Before a MRI examination, please 

inform your physician or the MRI Supervisor if you 

have: 

• a pacemaker 

• a metal plate, pin or other metallic implant 

• ever been wounded during military service 

• an artificial heart valve 

• an IUD 

• aneurysm clip 

• ever been a metal worker 

Metallic items within the body may cause discomfort 

or injury to you when please in the magnetic field, and 

may exclude you from the examination. Also, be sure 

to inform us if you are pregnant. 

How long does an examination take 

The average MRI scan takes 15 to 30 minutes with 

a complete examination running 30 to 45 minutes. 

During this time, several images may be obtained. 

What can I expect during the examination 

MRI is comfortable and easy for the patient. First, 

the technologist will help you lie down on a 

cushioned table. When you are comfortably 

4 • Radiology MRI

positioned for the examination, the table will be 

moved into the magnet. The technologist will step to 

the control area and remain in contact with you. 

As the MRI scan proceeds, you will hear a muffled 

thumping sound. Just relax - you may even take a 

nap – but try to lie as still as possible. Any movement 

during this time will blur the images. When scanning 

is complete, the technologist will return to assist you 

off the table. 

What can I do for best results 

Any metallic substance on your body part can cause 

a bright or blank spot on the picture. To help your 

doctor make the best diagnosis, please do not wear: 

• Hairspray 

• Mascara 

• Hearing aid 

• Any removable dental work 

• Jewellery 

• Spectacles 

In addition, you may find it easier to lie calm for several 

minutes at a time if you avoid drinking coffee or other 

caffeinated beverages before your scan. 

Radiology MRI • 5

Clinical Application 

Head and Neck 

MRI gives very detailed pictures of the brain and 

spine. Air and hard bone do not give an MRI signal, so 

these areas appear black. Bone marrow, spinal fluid, 

blood and soft tissue, like the brain, vary in intensity 

from black to white depending on the amount of fat 

and water present in each tissue, and the machine 

setting used for scan. The Radiologist compares the 

size and distribution of these bright and dark areas to 

determine whether the tissue is healthy. 

Body 

Nearly every part of the body may be studied with 

MRI. Organs within the chest and abdomen, such as 

the heart, liver, bladder, abdomen and kidneys can 

easily be seen. 

Bone and Joints 

MRI is very sensitive to changes in cartilage and bone 

structures resulting from injury, disease or aging. 

Clear pictures such as these often provide information 

not available through other medical investigation 

and may actually eliminate the need for exploratory 

surgery. 

6 • Radiology MRI

What is a Cardiac MRI 

Magnetic Resonance Imaging (MRI) uses 

radiofrequency waves and a strong magnetic field 

rather than x-rays to provide remarkably clear and 

detailed pictures of internal organs and tissues. The 

procedure is valuable in diagnosing a broad range 

of conditions in all parts of the body, such as heart 

and vascular disease, stroke, cancer and joint and 

musculoskeletal disorders. 

MRI is unique in that it can also create detailed images 

of blood vessels without the use of contrast material 

(although there is a trend toward the use of special 

non-iodinated MRI contrast material—for example, 

gadolinium). MRI requires specialised equipment 

and expertise and allows evaluation of some body 

structures that may not be as visible with other 

imaging methods. 

What are some common uses of Cardiac MRI 

MRI is becoming very important in the initial 

diagnosis and subsequent management of 

coronary heart disease. MRI can help physicians to 

look closely at the structures and function of the heart 

and major vessels quickly and thoroughly, without 

the risks associated with traditional, more invasive 

procedures. Using MRI, physicians can examine the 

size and thickness of the chambers of the heart, and 

determine the extent of damage caused by a heart 

attack or progressive heart disease. 

After a heart attack, for example, an MRI 

examination can help the cardiologist understand how 

well the heart is pumping, whether the flow of blood 

is blocked in any chamber or major vessel, whether the 

heart muscles are damaged or whether the lining of 

the heart is swelling. This critical knowledge is needed 

to administer prompt and effective treatment. 

8 • Radiology Cardiac MRI

An MRI specialist can demonstrate its potential 

for showing not only the structure, but also the 

function of the heart muscles, valves and vessels. 

Using MRI, the technologist can create movie-like 

images of the beating heart that doctors can use to 

diagnose a variety of cardiovascular problems. MRI is 

now being used as part of the traditional cardiac stress 

test to help physicians with earlier diagnosis and 

treatment of heart disease and to assess the patient’s 

recovery after treatment. 

How should I prepare for 

the procedure 

Due to strong magnetic 

field used for MRI 

that will pull on any 

iron-containing object in 

the body, MR technologist 

will ask whether you 

have a heartpacemaker or 

implanted defibrillator, implanted port, infusion 

catheter (often referred to by brand names such as 

Port-o-cath, Infusaport or Lifeport), intrauterine 

device (IUD), or any metal plates, pins, screws 

or surgical staples in your body. In most cases, 

surgical staples, plates, pins and screws pose no risk 

during MRI. Red dyes used in tattoos and permanent 

eyeliner may contain metallic iron oxide and could 

heat up during MRI; however, this is rare. 

You will be asked if you have shrapnel in your body 

or ever worked with metal. If there is any 

question of metal fragments, you may be asked 

to have an x-ray that will detect any metal 

objects. The radiologist or MR technologist may 

ask about drug allergies and whether you have 

undergone any surgery in the past. If you are or 

might be pregnant, mention it to the MR technologist. 

Radiology Cardiac MRI • 9

The new patient-friendly MRI System of JPMC 

How is the procedure performed 

The patient is placed on a sliding table and 

positioned comfortably for the MRI examination. Then 

the radiologist and technologist will leave the room, 

and the individual MRI sequences are performed. 

The patient will be able to communicate with the 

technologist at any time by using an intercom. 

Depending on how many images are needed, the 

examination will generally take 15 to 45 minutes, 

although a very detailed study may take longer. You 

will be asked not to move during the actual imaging 

process. 

For examination of the heart, contrast material 

may be used to enhance the visibility of the heart’s 

chambers and major vessels. A small needle 

connected to an intravenous line is placed in an arm 

or hand vein. A saline solution will drip through 

the intravenous line to prevent clotting until the 

contrast material is injected, about two-thirds of the 

way through the exam. 

When the examination is over, the patient will be asked 

to wait until the images are examined to determine if 

more images are needed. 

10 • Radiology Cardiac MRI

Who interprets the results and how do I get them 

A radiologist, who is a physician experienced in MRI 

and other radiology examinations, will analyse the 

images and prepare the report together with a trained 

Cardiologist 

What are the benefits 

• Images of soft-tissue structures such as the heart 

and major vessels are clearer and more detailed 

than from other imaging methods. 

• The findings on MRI makes it an invaluable tool 

in early detection and evaluation of many 

diseases. 

• Even without the use of contrast material, MRI 

often shows sufficient details of the heart which 

are invaluable in diagnosis and treatment 

planning. 

• When it is used, MRI contrast material is less 

likely to produce an allergic reaction than the 

iodine-based materials used for conventional 

x-rays and CT scanning and does not contain 

the radioisotopes used in nuclear medicine 

examinations. 

• MRI enables the detection of abnormalities that 

might be obscured by bone tissue with other 

imaging methods. 

• MRI can help physicians evaluate the function 

and the structure of the heart muscles and 

valves. 

• MRI does not require exposure to radiation or 

the introduction of radioisotopes to the body. 

What are the limitations of a Cardiac MRI 

In most cases, the exam is safe for patients with 

metal implants, with the exception of a few types of 

implants, so patients should inform the technologist of 

an implant prior to the test. The examination must be 

used cautiously in early pregnancy. 

Radiology Cardiac MRI • 11

MRI of the breast is not a substitute for 

mammography or ultrasound imaging but rather is 

a supplementary tool for detecting and staging 

breast cancer and other breast abnormalities. 

MR imaging does not involve radiation, the 

procedure can be used to screen women below 40 

years old and to increase the number of screenings 

per year for women at high risk for breast cancer. 

MRI is used to: 

• evaluate any abnormalities detected by 

mammography. 

• identify early breast cancer not detected 

through other means, especially in women 

with dense breast tissue and those at high 

risk for the disease. 

• screen for cancer in women who have 

implants or scar tissue that might jeopardise 

an accurate result from a mammogram. 

• determine the integrity of breast implants. 

• distinguish between scar tissue and recurrent 

tumors. 

• assess multiple tumour locations. 

• check the progress of chemotherapy. 

• look for multiple tumours prior to breast 

conservation surgery. 

• determine whether the cancer detected by 

mammography or ultrasound has spread 

further in the breast or into the chest wall. 

• determine how much the cancer has spread 

beyond the surgical site after a breast biopsy 

or lumpectomy. 

• provide additional information on a diseased 

breast to make treatment decisions. 

Radiology Breast MRI • 13

Benefits: 

• MRI has been shown to detect small breast 

lesions that are sometimes missed by 

mammography. 

• MRI can successfully image dense breast, 

commonly in younger women, as well as 

breast implants. 

• MRI contrast material is less likely to produce 

an allergic reaction than the iodine-based 

materials used for conventional x-rays and 

CT scanning. 

• MRI is a non-invasive imaging technique that 

does not require exposure to radiation. 

• MRI provides more clear and detailed images 

of the soft-tissue structures of the body 

than other imaging methods. The detail 

makes MRI an invaluable tool in early 

diagnosis and evaluation of tumours. 

Without contrast material, an MRI of the breast can 

show: 

• breast tissue density. 

• cysts. 

• enlarged ducts. 

• hematomas. 

• leaking or ruptured breast implants. 

14 • Radiology Breast MRI

By comparing breast images taken before and after 

contrast material injection, an MRI examination 

can determine: 

• if there are breast abnormalities. 

• whether an abnormality looks benign (noncancerous) 

or maligant (cancerous). 

• the size and location of any abnormality that 

looks malignant. 

• the presence of enlarged lymph nodes. 

Magnetic Resonance (MR) Imaging of Breast Implants 

MR imaging of the breasts (also called MR 

Mammography or Breast MRI) can be used to image 

breast implants to check for ruptures or leaks. MR 

imaging may also be used as an adjunctive tool 

to conventional mammography for women with 

implants. 

MR mammography can image the breast tissue that 

is compressed by an implant. Magnetic resonance 

is the imaging method of choice to evaluate breast 

implants and to check for ruptures or leaks. MR 

imaging provides very good spatial resolution 

(detail) and excellent contrast resolution and enables 

MR to clearly visualise implant condition. 

Radiology Breast MRI • 15

What is CT Scanning 

CT (Computerised Tomography or Computed 

Tomography) scanning, which is also known as CAT 

scanning, is an advanced scan of cross-sectional 

images of the whole body such as head, chest, 

abdomen and spine as well other small body parts. 

Offering New Levels of Excellence in CT 

The SOMATOM Sensation 64-Slice CT Scanner 

takes scanning to new levels, employing the latest 

and fastest technology to create clear, detailed 

images of your body that will help your doctor 

make the best diagnosis and treatment for you. 

Other capabilities include the ability to perform 

pQCT (osteoporosis evaluation) and dental CT (dental 

implants). 

The 64-slice CT scanner obtains 64 slices per 

rotation with unmatched sharpness, detail, clarity 

and speed. With this scanner, patients will be able to 

experience a more comfortable and shorter 

examination. Patients will also benefit from the 

superior diagnostic imaging quality that can help 

detect many diseases and conditions earlier (including 

heart disease), leading to a faster and more effective 

treatment. 

While the traditional method of identifying 

heart disease has been cardiac catheterisation, 

the 64-slice CT scanning enables physicians to 

visualise a patient’s arteries without the potential 

complications associated with more invasive 

Radiology Multi-Slice (64-slice) CT Scanning • 17

diagnostic examinations. 

With a 64-slice CT scan, 

radiologists can clearly 

see if there is soft plaque, 

arterial stenosis (narrowing) 

or blockages in a patient’s 

heart arteries, and other early warning signs of 

cardiovascular disease. 

A New Level of Speed 

• Engineered for speed and accuracy, an 

examination can take as little as 10 minutes, 

from scan to diagnosis. * Previously, patients 

suspected of heart attack might undergo a 

stress test, EKG study, and blood testing, 

which could take much longer. 

• Allows doctors to evaluate the most common 

causes of acute chest pain with a single scan. 

• Permits some patients to avoid surgical 

procedures such as cardiac catheterisation. 

A New Level of Comfort 

• 64-slice technology requires that you hold 

your breath for shorter periods than the older 

16-slice technology—for example, a scan of 

the blood vessels in your heart now requires 

that you hold your breath for 9 seconds, 

compared to 17 seconds with the 16-slice 

equipment. 

A New Level of Clarity 

• Provides excellent image quality, regardless of 

your size and weight. 

• Images the beating heart in real time, 

permitting evaluation of its valves and the 

motion of its walls in greater detail. 

18 • Radiology Multi-Slice (64-slice) CT Scanning

A New Level of Versatility 

• The SOMATOM Sensation 64 can also be used 

when studying: 

p Cardiovascular conditions, including 

stroke and blood clots. 

p Other conditions involving the brain, 

colon, or lungs. 

What You Don’t Know Can Hurt You 

Knowing what’s happening in your body can save 

your life. The advanced diagnostic imaging of the 

new SOMATOM Sensation 64 CT Scanner at 

JPMC reveals clear, sharp pictures of your organs, 

tissue and blood vessels down to the smallest 

detail – all in as little as 10 seconds. 

The SOMATOM Sensation 64 CT Scanner offers 

patients: 

• Completely non-invasive, painless diagnostic 

examination of the heart. 

• A level of clarity and detail of the heart 

previously only possible with an invasive 

procedure. 

• Routine CT scans which are able to detect soft 

plaques. 


Preparation for the procedure 

The patient is usually asked to fast 3-4 hours before 

the CT examination in case intravenous contrast 

needs to be injected to facilitate a clearer view of 

the organs being studied. The contrast is a 

colourless, non-ionic agent fluid, which is injected 

via a vein (arm or leg). This may cause a warm or 

flushed sensation. Oral contrast agent may also be 

administered, especially for abdomen and pelvic 

scans. 

If contrast agents are required, the patient will 

be briefed and any allergies to food or medicine 

will be ascertained. Prescribed medication may be 

administered but insulin treatment for diabetics 

should be delayed until the patient resumes food 

consumption in order to avoid an insulin reaction. 

The patient will also change into a hospital gown 

and remove items such as glasses, jewellery, dentures 

and hearing aids etc, which interfere with the x-ray. 

After the CT Examination 

Following the CT examination, the patient is required 

to stay on the CT table until the radiographer confirms 

the necessary examination has been obtained. The 

patient can then return to the ward or home. 

Unless there are other scans scheduled, the patient 

may eat normal food and should drink plenty of 

fluid to eliminate any contrast agent from the body. 

Are there any risks with CT Scanning 

CT scanning is a medical imaging procedure 

performed to gain further information about a 

patient’s illness. The risk from medical x-ray 

examinations, if it exists at all, is extremely small. 

The benefits far outweigh the risk. 

If there are any further queries, please do not hesitate 

to contact the Radiologist or Radiographer. 


Types of CT Scan Images 

Isotropic Volume 

Acquisition & Multi-planar 

Reconstruction 

In older scanners, reconstruction 

in any plane, except the axial 

plane, resulted in degradation 

of the image. In the 64-slice 

CT scanner with isotropic 

volume acquisition and multi-planar reconstruction 

images in any plane are of the same quality. 

Organs and pathology can be viewed from multiple 

diretions to improve diagnostic accuracy. 

3D Imaging and Volume 

Rendering 

In the 64-slice Scanner, 

volume rendering allows 

tissue layers to be stripped 

away to show the areas of 

interest. The resultant image can 

be viewed in either 2D or 3D 

and in their natural anatomical colour. With real-time 

multi-planar imaging (MPR), the radiologist can view 

the images in any plane instantaneously. 

Vascular Imaging 

Head to toe images of 

the arterial system, in colour and 

3D are performed following 

intravenous injection of 

contrast. Arterial catheterisation 

is no longer necessary. This 

allows precise pre-operative 

examination of vascular disease and accurate 

preoperative assessment for stenting procedures. 

Radiology Multi-Slice (64-slice) CT Scanning• 21

Virtual Colonoscopy 

The abdomen is scanned 

in a single breath hold. 

As well as reviewing 

the axial images, the 

radiologist performs 

a computer simulated 

colonoscopy. The results 

appear to be as good as a 

conventional colonoscopy and a virtual colonoscopy 

ensures adequate visualisation of the caecum in every 

case. The examination is cost effective as the patient 

is not sedated and may return to work immediately. 

The examination fee is also lower than the 

average fee for colonoscopy. The examination is 

used for the detection of apolyps and early colonic 

cancer. Symptomatic patients should be referred for 

conventional colonoscopy or barium enema. 

Carotid and Intracerebral 

Vascular Imaging 

The angiography produces 

exquisite detail of the 

carotid vessels and 

intracerebral vessels. This 

only requires intravenous 

contrast and obviates 

the need for femoral 

artery catheterisation. Angiography of the carotids 

and intracerebral vessels can be performed at the 

same time as the initial head CT in stroke and 

subarachnoid haemorrhage. Perfusion software 

allows immediate assessment of the degree of 

ischaemia and cellular damage. 


Cardiac CT 

Anatomical diagnostic images of the heart and 

coronary vessels are produced in seconds and 

post processing allows each vessel to be viewed in 

continuity, which provides a quantitative 

assessment of stenoses and the assessment of the 

lipid, fibrin or calcium content of hard or 

soft plaque. This examination does not require 

hospitalisation or arterial puncture. Positive 

examinations are referred on for interventional 

treatment as necessary. HeartView is ideal for the 

postoperative assessment of stents. In addition, a 

calcium score of the coronary vessels is calculated 

to help assess risk. 

CT Oncology 

The CT Oncology offers you a unique 

and innovative combination for diagnostic 

imaging, evaluation and follow-up in your 

diagnostic oncology setting. Our intuitive syngo 

computer-assisted reading tools, combined with 

intelligent evaluation, automated follow-up, and 

image guided intervention, offer you a new level of 

confidence for preventive care, staging, follow-up 

exams, and real-time guided biopsies. 

Comprehensive tumour perfusion enables a fast 

and easy visualisation of tumour enhancement 

and aids you in differentiating tumours. Fusing 

images from PET or SPECT with high resolution 

CT images not only helps to better localise 

tumours, but also in therapy planning. Our 

solutions for interventional CT extend your 

clinical spectrum towards differential diagnosis 

and treatment, turning data into a diagnostic 

outcome within minutes. 


What is Osteoporosis 

Osteoporosis, characterised by thin, weak bones, 

can be a silent disease. It often progresses without 

symptoms. In fact, what may seem like simple back 

pain could actually be spinal fractures you do not even 

know about. 

By about age 20, the average woman will have 

acquired most of her skeletal mass. Bone mass reaches 

its peak by the age of 30-35. Afterwards, bone mass 

begins to decline at a steady rate. After menopause, 

the rate of bone loss increases significantly. 

As you lose bone mass, your bones become 

thinner and more fragile. Women may lose up to 1/3 

of the bone mass in their spines in the first 6 years 

after menopause, making them more susceptible to 

fractures. When your doctor looks at your bone health, 

he/she will compare the thickness of your bones to 

that of a normal young adult. That comparison is 

measured in units called Standard Deviation (SD) 

- a mathematical term that describes the difference 

between each individual measurement and the mean 

(average). 

When a considerable amount of bone is lost, you 

reach a point when you have significantly less bone 

than normal, a condition known as osteopenia. 

At this point, you have 1 to 2.5 SD less bone than a 

normal young adult. With further bone loss, the 

normal structure of the bone is disrupted as well. This 

is the onset of osteoporosis, where your bone mass 

would be more than 2.5 SD below that of a normal 

young adult. Osteoporosis is a disease characterised 

by low bone mass and structural deterioration of 

bone tissue, leading to bone fragility and an increased 

susceptibility to fractures. 

Radiology Peripheral QCT • 25

How common is Osteoporosis 

Osteoporosis is responsible for more than 1.5 

million fractures worldwide annually. Ten million 

individuals already have osteoporosis, and 18 

million more have low bone mass. Approximately 

80% of those affected by osteoporosis are women, 

putting them at increased risk for fracture. 

For many women, osteoporosis is a silent disease that 

develops with few warning signs. 

After menopause, the bones in the body may become 

thinner and weaker. Over time, bone loss can lead to 

increased risk of fractures. 

Each year, there will be more osteoporotic fractures in 

women than strokes, heart attacks, and breast cancers 

combined. 

Up to half of women over 50 years old will break 

a bone due to osteoporosis in their lifetime. 

Symptoms 

Osteoporosis is often called the “silent disease” 

because the loss of bone can occur without symptoms. 

Many women may not even know that they have 

osteoporosis until they suffer a fracture. Even when 

a bone is fractured, the patient may not immediately 

recognise the true nature of her condition. 

26 • Radiology Peripheral QCT

A collapsed vertebra may initially be painless, or 

it may be felt as severe back pain. Later, the patient 

may experience loss of height, spinal deformities, or 

stooped posture. 

Risk factors 

The more bone mass you have at age 30-35, the less 

likely you are to develop osteoporosis. There are many 

factors that determine how much bone mass you will 

have - genetic, nutritional, and environmental. While 

you may have control over some of these, e.g., calcium 

intake, you cannot change most of these factors. 

Certain people are more likely to develop 

osteoporosis than others. Factors that increase the 

likelihood of developing osteoporosis are called 

“risk factors.” These include: 

• Being female 

• Thin and/or small frame 

• Advanced age 

• A family history of Osteoporosis 

• Being postmenopausal, including early or 

surgically-induced menopause 

• Abnormal absence of menstrual periods 

(amenorrhea) 

• Anorexia nervosa or bulimia 

• A diet low in calcium 

• Use of certain medications, such as 

corticosteroids, thyroid replacement therapy, 

and some anticonvulsants 

Radiology Peripheral QCT • 27

• An inactive lifestyle 

• Cigarette smoking 

• Excessive use of alcohol 

• Being Caucasian (white) or Asian, although 

African Americans and Hispanic Americans 

can be at risk as well 

Diagnosis of Osteoprosis peripheral QCT (pQCT) 

The most commonly used method of evaluate 

bone mineral density (BMD) in osteoporosis is the 

Quantitative Computed Tomography. This allows 

selective measurement of the trabecular compartment 

of the vertebrae by excluding cortical bone and 

extraosseous calcifications. pQCT measures the true 

volumetric BMD. Please consult your physician for 

more details. 

The pQCT examination 

During the examination, the patient lies on a narrow 

table, which slides into the doughnut-shaped ring in 

the centre of the scanning machine. The x-ray tube 

then routes around the patient. 

The examination will take 10-15 minutes. During the 

examination, the patient will hear humming, buzzing 

or clicking sounds from the CT machine. The table 

moves every few seconds to position the patient for a 

new scan. Keeping still will ensure clearer images. 

Are there any risks with pQCT 

pQCT is a medical imaging procedure performed to 

gain information about BMD. The risk from medical 

x-ray examinations, if it exists at all, is extremely small. 

The benefits far outweigh the risk. 

If there are any further queries, please do not hesitate 

to contact the Radiologist or Radiographer. 

28 • Radiology Peripheral QCT

Breast cancer is one of the most life threatening cancers in 

women. 

If breast cancer is detected early there is a good chance that 

it can be treated successfully. 

It is up to you – a mammogram could save your life! 

What is a Mammogram 

A mammogram (breast x-ray) is a picture of the breast 

tissue. This picture can show the presence of cancer 

well before a lump can be felt. These early cancers 

can usually be treated successfully before they have a 

chance to spread. 

Who should have a Mammogram 

Women are more likely to develop breast 

cancer as they grow older. With the approach of 

menopause the risk becomes greater, so a regular 

x-ray is important from then on. It is recommended 

worldwide that women who are above the age of 45 

seek mammogram screening every one to two years. 

Most doctors recommend that women with a strong 

family history of breast cancer should commence 

screening ten years before the age at which their 

relative was diagnosed. 

How is a Mammogram taken 

To get a clear picture, the breast tissue needs to be 

compressed for a few seconds. This may be briefly 

uncomfortable. Usually two x-rays are taken of each 

breast. A mammogram involves a very low dose of 

radiation. The whole procedure takes about 20 

minutes. 

30 • Radiology Mammogram (Breast X-ray)

How often should I have a Mammogram 

Usually once every two years. If there are reasons for a 

more frequent examination, your doctor will tell you. 

NOTE: If you have had a previous mammogram, 

please bring the films with you, if possible. 

What should I do before I come for a 

Mammogram 

• Women whose breasts become tender before 

their periods find it more comfortable to have 

an x-ray during or just after a period. 

• For convenience, a two piece outfit such as 

slacks and blouse is recommended when 

having a mammogram. You will be given a 

gown to wear. 

• Please do not wear talcum powder or 

deodorant. These can show on the x-ray picture. 

• If you have breast implants, please tell the 

receptionist when making your appointment as 

the examination will take a little longer. 

What happens if they find something 

The doctor will contact you to discuss the best course 

of action. 

• Most breast abnormalities are not cancerous. 

• The earlier a cancer is detected, the greater the 

likelihood of a successful treatment. 

Can I be sure that I am alright if the Mammogram 

results are normal 

Mammography picks up about 90% of breast cancers. 

There are some cancers which will not be detected 

by an x-ray. If you notice a breast lump, pain or a 

nipple discharge, you should see your doctor straight 

away, even if the mammogram is normal. It is 

still important for a woman who has had a normal 

result to continue to have regular mammograms, 

because changes in the breast develop over time. 

Radiology Mammogram (Breast X-ray) • 31

What else should I do 

As part of total breast care we also suggest you: 

• Ask your doctor to check your breasts once a 

year. 

• Practice regular Breast-Self Examination 

(BSE). 

See your doctor straight away if you notice any 

changes with your breasts. 

Where can I get Mammogram 

JPMC’s Diagnostic Imaging Department has the 

latest low dose mammographic equipment. The 

examination takes about 20 minutes and appointments 

are encouraged. 

REMEMBER: 

LOOK 

feeL 

ACT 

ASK 

BSE takes only a few minutes each month. It is one 

way you can do something for your own health. 

What do I check for 

• Lumps, even if they are painless. 

• Thickening in your breast. 

• Any discharge from your nipple. 

• Any other changes. 

32 • Radiology Mammogram (Breast X-ray)

What is ultrasound 

Ultrasound is an easy and non-invasive way to 

see the internal structures of the body by sending 

high frequency sound waves through skin. In an 

abdominal examination, ultrasound produces images 

to be seen on most of the major organs including the 

liver, gallbladder, pancreas, spleen kidneys and large 

blood vessels. 

The principle behind ultrasound or “sonar” is the 

same as what was used during World War II to locate 

enemy submarines beneath the sea. The machine, 

a transducer, sends a brief pulse of sound (about 

a millionth of a second long) into the body. This 

sound travels into the abdomen and when it reaches 

a structure, the travelling pulse will send back a little 

echo. With the use of high-speed computer, an image 

of the organ being examined is seen on the TV monitor 

of the machine. Sounds produced by the transducer 

are very high pitched and are unable to be heard by 

humans. 

How long will it take 

The length of time for all examinations will 

vary depending on the specific reasons for your 

examination. For some studies, such as examination 

of the gallbladder for stones, may require only 15 

minutes. For a complete study of the abdominal organs 

or pelvis, 45 minutes or more may be required. 

Is ultrasound safe 

Diagnostic ultrasound has been in use since the 

late 1950’s. No known adverse biological effects on 

patients resulting from this usage have ever been 

reported. Although the possibility exists that such 

biological effects may be identified in the future, 

current data indicates that the benefits to patients 

of the prudent use of diagnostic ultrasound far 

outweigh the risks, if any, that may be present. 

34 • Radiology Ultrasound

Will it hurt 

There is little or no pain involved in an ultrasound 

examination of your abdomen, although, there may 

be some discomfort from maintaining a full bladder. 

A gel-like material is applied to your abdomen and 

the instrument is then placed on the skin surface to 

provide better contact between the transducer and the 

skin. This gel may feel slightly cold and even though 

it wipes off easily, it is a good idea to wear clothing 

that is easily washable. 

What are the limitations of the examination 

As bone attenuates sound waves, ultrasound cannot be 

used to examine the bones surrounding the abdomen, 

such as your ribs. Also, as sound is weakened as it 

passes through layers of tissue, results from patients 

who are obese are not of the same quality as those of 

people who are thin. 

Are there any special preparations for the 

examination 

If the gallbladder is to be examined, you should have 

nothing to eat or drink except water for 6 hours before 

the procedure. This is because food and drink causes 

the gallbladder to contract, preventing adequate 

examination with the ultrasound. 

Radiology Ultrasound • 35

When should an Ultrasound examination of the 

abdomen be done 

There are many reasons for examining the abdomen 

with an ultrasound. Among the common reasons when 

an ultrasound examination of the abdomen should be 

done are : 

• To look for causes of upper abdominal pain, 

which may be related to problems of the liver, 

gallbladder or kidneys. 

• To detect gallstones. 

• To determine abnormalities of the liver or 

spleen. 

• To evaluate the kidneys for blockage. 

• To look for enlargements (aneurysms) and other 

abnormalities of abdominal blood vessels. 

In some cases, the ultrasound may not be able to 

provide all the information your doctor requires, in 

which case, additional studies may be required. 

Why should I have an Ultrasound examination 

during pregnancy 

The most common reason for having an ultrasound 

examination is to determine the approximate age 

and position of the baby and to make sure the baby 

is growing normally. Age can be determined early in 

the pregnancy (2-3 months) by measuring the length 

of the baby. Later, at 4-7 months, age is derived by 

measurements of the head and the length of the 

femur (the long bone inside the thigh). These 

measurements are then compared to a table that list 

averages of normal baby growth. 

36 • Radiology Ultrasound

With the use of ultrasound, the amount of fluid 

surrounding the baby, as well as the placenta 

can be seen. The placenta’s position is helpful in 

determining what kind of delivery you will have 

(vaginal or caesarian) and whether the baby will 

need any special medical attention immediately after 

delivery. Early in pregnancy, it may be necessary to 

scan with a special transducer placed in the vagina to 

see the baby. 

Are there any special preparaton for Pelvic 

Examination 

Depending on how far along you are in the 

pregnancy, the only preparation you may be asked 

to make is to have a full bladder by drinking about 

4-6 glasses of water an hour before the procedure. The 

reason for this is that high frequency sound waves 

used in ultrasound reveal well through liquid, but not 

through gas or air. Since the uterus is located in the 

pelvis behind loops of bowel containing gas and air, 

it is important to fill the bladder (also located in the 

pelvic area) with fluid to displace the bowel and 

provide a clear window for viewing the baby. 

Radiology Ultrasound • 37

Physiotherapy Department 

Orthopaedics Clinic Ext. 2288 

Physiotherapy Ext. 2323

Untitled - Jerudong Park Medical Centre

Create successful ePaper yourself

Delete template?

Save as template?