Introductions of Imaging Services Available

2.  Discovery of X-rays was accidental.
 Wilhelm Conrad Roentgen on the 8th of November
1895.
 Introduced in the Malay Peninsula on February
1897, with the installation of the first x-ray
machine in South East Asia. This occurred in
Taiping, Perak.
 Mammographic services were started in KLGH in
1972.
 Ultrasound came on the scene in 1974 when the
Faculty of Medicine, University Kebangsaan
Malaysia bought the first machine.
 1977 saw the introduction of Computer
Tomography when a scanner was installed in
Institute of Radiotherapy and Oncology, KLGH.

3.  1. General X-ray
 2. Hysterosalphingraphy (HSG)
 3. Ultrasound
 4. Computed Tomography (CT)
 5. Magnetic Resonance Imaging (MRI)
 6. Procedures:
 A. Fine needle aspiration.
 B. Biopsy
 C. Drainage

4. ULTRASOUND

5.  Safe and relatively painless.
 do not use ionizing radiation.
 for a study of the gallbladder, you may be asked to eat a fat-free meal on
the evening before the test and then to avoid eating for eight to 12 hours
before the test.
 for ultrasound of the kidneys, you may be asked to drink liquid about an
hour before the test to fill your bladder.
 LIMITATIONS: Not an ideal imaging technique for air-filled bowel or
organs obscured by the bowel since ultrasound waves are disrupted by air
or gas.

8.  Recent advances in mammography equipment and techniques have
resulted in women now only receiving a small radiation dose
(0.7mSv), which is about the same as that received every year from
normal background radiation.
 The benefits of being screened for breast cancer far outweigh any
potential risks of radiation from a mammogram examination.
 Mammography is the most effective, non invasive and the best way
to detect early breast cancer especially when it is too small to be felt
by the patient or the doctor.
 Breast screening is now available to all women aged 40 and above.
 The present guidelines for screening of asymptomatic women
(women who do not have any symptoms related to the breast) are:
 At age 35-40: baseline mammogram
 At age 40-49: mammograms at one or two year intervals
 At age 50 and above: annual mammograms

10.  The women are advised not to use
deodorant, talcum powder or perfume
which may cause artifacts on the X-ray film.
 The mammogram may miss up to 5-15% of
cancers in the breast. The management of
patient should be based on clinical
grounds.

11.  Incidence: 1 in 10 females
 Approx. 3000 new cases are diagnosed each
year
 1 in 10 cancer cases will be breast cancer
 Mammogram Reduce the risk of death from
breast cancer for population aged 50 – 65 by
approx. 29%
 Accuracy 90 %

12.  FINDINGS
◦ MASSES
◦ CALCIFICATIONS
◦ ARCHITECTURAL DISTORTION
◦ DENSITY
◦ SKIN / AXILLARY NODES

17. CT SCAN

19.  the chest gives a radiation dose equivalent to
400 chest radiographs (chest tomography 8 mSv;
chest radiography=0.02 mSv).
 the thoracic spine, mediastinum, abdomen, liver,
pancreas, kidney, lumbar spine, and pelvis is
associated with effective doses of >5 mSv
(equivalent to over 250 chest radiographs) and in
some cases as high as 30 mSv (equivalent to
1500 chest radiographs).
 Furthermore, the dose to the breast in many
thoracic examinations ranges from 18 to 33 mSv.
 The dose to the lens of the eye is around 30 mSv in
computed tomography of the head, about 70 mSv
in scanning of sinuses, and about 10-130 mSv in
scanning for orbital trauma.

22.  It is safe for women who are more than four
months pregnant to undergo this
examination.
 The total duration of the examination varies
from 30-90 minutes depending on the part
of the body being examined.

23.  It is important to understand that the effect
of the powerful magnet is typically only
exhibited on iron-containing objects.
 Most other metals (titanium, aluminum,
copper, etc.) will not experience the
ferromagnetic forces.
 Titanium was developed over the past 15
years as a viable surgical metal. At present,
almost all neurosurgical clips are made of
titanium.

24.  MRI can cause serious injury and even death in those with
metal embedded in their bodies. Patients with the following
objects inside the body generally cannot undergo an MRI
examination:
 Battery-operated devices (eg. cardiac pacemakers, bladder
pacemakers, nerve-stimulating devices of various types for
inner ear and spinal diseases).
 Metallic foreign bodies
 Metallic implants
 At the time of examination, female patients should not use
any facial make-up as this may interfere with the image.

25. THANK YOU…