What is 3D Mammography?

Recently in our blog, we posted about how a large study showed the benefits of adding 3D mammography (also called breast tomosynthesis) to regular mammography. In this blog post, we answer a few questions about 3D mammography.

Q: Who might benefit from adding 3D mammography to their traditional mammogram?
A:  All women could potentially benefit from 3D mammography since it has been shown to increase cancer detection while lowering the risk of false-positive results. However, it appears that women with dense breasts may see the most benefits. A recent Yale study found that women with extremely dense breasts had a 57% reduction in being called back for additional testing when 3D mammography was used. Younger women also had reduced call back rates when 3D mammography was used.

Q: Does 3D mammography replace my regular mammogram?
A: No. 3D mammography is an add-on to your regular mammogram. It allows physicians to see a
     3-dimensional view of your breast tissue and helps them to identify even very tiny tumors.

Q: Will there be more compression necessary to get the 3D images?
A. No! Your breast will be under the same amount of pressure as during a regular mammogram. The X-ray tube makes an 8-second arc over your breasts, while 15 low-dose images are taken from various angles. These images are then put into a special computer program that creates the 3D images.

Q: Is there more radiation exposure from adding 3D to my regular mammogram?
A: Yes, however the radiation exposure is still well below FDA levels. Zwanger-Pesiri Radiology is committed to using the lowest dose of radiation possible by utilizing state-of-the-art technology to reduce radiation exposure.  We also participate in the Image Wisely program to eliminate unnecessary scans and lower radiation doses.

Q: How specifically could 3D mammography benefit women with dense breasts?
A:  In a mammogram, fatty tissue shows up dark, while dense breast tissue shows up white. Unfortunately, potentially cancerous spots also show up white, making them harder to spot in dense breasts. 3D imaging creates pictures of millimeter-thin slices of breast tissue, helping radiologists to see through overlapping tissue and better identify potential cancers. Radiologists end up seeing 70 to 100 views of each breast, rather than just two images using conventional mammography. More views equals more accurate images which means better diagnoses.

Q: Which Zwanger-Pesiri Radiology locations offer 3D mammography?
A:  ZPR is pleased to offer 3D mammography at all of our locations, except East Setauket.

If you have any questions about 3D mammography, feel free to email us!

Heart-Healthy Tips

Hearts are not just for Valentine's Day ... February is also American Heart Month. According to the Centers for Disease Control and Prevention (CDC), about 715,000 Americans suffer from a heart attack and about 600,000 die from heart disease every year. Heart disease is the number one cause of death for both men and women in this country.

As a general rule, heart disease doesn't happen overnight. The most common form of heart disease -- Coronary Artery Disease (CAD)-- happens when plaque builds up in the arteries that supply blood to the heart. The good news is that there are steps you can take to reduce the risk of heart disease. It's far easier to prevent heart disease from happening in the first place than it is to treat it. Here are some tips for avoiding a "broken heart:"

- Eat a heart-healthy diet. Eat a diet low in saturated fats, trans fats, cholesterol and sodium, and increase your intake of fiber, fresh fruits and vegetables, and whole grains. Watch your portion sizes. Avoid processed, fried and fast-foods. If this sounds too daunting, at least start by cutting back on your fat intake and increase your intake of fresh fruits and vegetables.

- Stop smoking! Smoking is bad for almost every part of you, but it's particularly bad for your heart because it causes it to have to work harder. Nicotine narrows your blood vessels and increases your heart rate and blood pressure, and carbon monoxide in cigarette smoke  replaces some oxygen in the blood, raising blood pressure and forcing your heart to work harder to pump blood. The good news? The minute you stop smoking you lower your risk of heart disease, and the risk drops dramatically within just one year. So make the choice to stop now.

- Maintain a healthy weight. This is good advice for your health in general. Excess weight leads to conditions that increase the risk of heart disease such as diabetes, high blood pressure and high cholesterol. Head this disease off at the pass by maintaining a healthy weight. Are you in the right weight range? Use a Body Mass Index calculator to find out -- you can find one here. Another way to tell if you're maintaining a healthy weight is to measure your waist. Men are considered overweight if their waist measurement is greater than 40 inches; women are considered overweight if their waist measurement is greater than 35 inches.

- Exercise. Experts suggest that regular daily exercise can reduce the risk of fatal heart disease. They recommend 30 to 60 minutes of moderate exercise, most days of the week. But ANY amount of exercise provides health benefits, so if you can't commit that much time, just do what you can. And remember that walking, gardening and housework all count as exercise. Simple steps, like parking farther away from your destination, or taking the stairs rather than the elevator, can help you add exercise to your day in an easy way.

- Get regular health screenings. Certain conditions, such as diabetes, high blood pressure and high cholesterol, can dramatically increase your risk of heart disease by causing damage to your heart and blood vessels. You should be regularly screened by your physician for these conditions, since managing them is the key to staying heart-healthy.

- Manage chronic diseases. If you have diabetes, high blood pressure or high cholesterol, it is essential that you take your medications as directed, in order to prevent damage to your heart. Because there are few noticeable symptoms of these conditions, people sometimes feel that they can be ignored. They can't. There is a high correlation between uncontrolled diabetes and heart attack.

- Drink alcohol only in moderation. Too much alcohol can increase blood pressure, thus putting a strain on your heart. Stick to no more than one drink a day for women, two for men. A compound in red wine, called resveratrol, shows some promise in protecting the heart, so consider a glass of wine rather than hard liquor.

Taking care of yourself now can mean less problems down the road. Coronary CT Angiography (CCTA) is a test which allows doctors to check for narrowed arteries in the heart that can put you at risk for a heart attack. Cardiac MRI is an MRI scan of the heart and blood vessels, and provides 3-dimensional pictures, as well as moving video pictures of the heart beating and blood flowing through the chambers and valves.

At Zwanger-Pesiri Radiology, we care about our patients as people and wish you a heart-healthy February and beyond.

What You Should Know About Your Thyroid

January is Thyroid Awareness Month. You may be aware that you HAVE a thyroid, but are you aware of the important role your thyroid plays in how your body functions?

The thyroid is a small butterfly-shaped gland located in your neck, above your collarbone. It it one of your endocrine glands and produces hormones which, among other things, regulates your metabolism, including your body temperature and your body's consumption of oxygen and food. Thyroid disease, however, is quite common, especially among women.

Take this online quiz to find out if you could have a thyroid problem.

The most common thyroid problem in this country, affecting millions of people (most of them women), is hypothyroidism. Hypothyroidism is when the thyroid gland is under active, and is not producing enough hormone to properly run the body's metabolism. This can happen due to an autoimmune disorder called Hashimoto's thyroiditis which causes the body to attack the thyroid, resulting in the gland producing less hormone. Other causes include having the thyroid removed and exposure to excessive amounts of iodine. Symptoms of hypothyroidism include weight gain, fatigue, and sensitivity to cold. Hypothyroidism can be identified by a simple blood test, and is treated by hormone supplementation to get the levels up to normal. Take this online quiz to determine if you have symptoms of hypothyroidism.

The second most common thyroid issue is hyperthyroidism -- or having an overactive thyroid gland which produces too much hormone. This can happen due to an autoimmune disorder called Graves' disease, which causes the body to send false signals to the thyroid gland telling it to produce hormone when it shouldn't. Other causes can include certain thyroid nodules and thyroiditis. Symptoms of hyperthyroidism include weight loss, sensitivity to heat, and a fast heart beat. Hyperthyroidism can also be identified by a simple blood test, and is treated in a variety of ways once the specific cause is determined. Take this online quiz to determine if you have symptoms of hyperthyroidism.

Thyroid nodules are fluid-filled cysts which are often benign. Your doctor may recommend a thyroid ultrasound to evaluate a nodule. A thyroid biopsy might be ordered to rule out thyroid cancer. 

For more information about thyroid disease, diagnosis and treatments, visit the American Thyroid Association.

Adding 3D Tomography to Mammography Aids in Cancer Detection, Reduces False-Positives

Results of a new, large-scale study have revealed that adding 3D tomography to conventional 2D mammography increases cancer detection by as much as 40%, while lowering false-positive results by 15%. The study results published in the journal, Radiology, showed that adding 3D tomography increased detection rates for cancer, and reduced the number of false-positives, resulting in more accurate diagnoses. According to the researchers, the use of mammography plus tomosynthesis for breast cancer screening "resulted in a significantly higher cancer detection rate and enabled the detection of more invasive cancers."

3D tomography improves a physician's ability to detect very small tumors which might not show up on a regular mammogram, especially in women with dense breasts.

Another study by Yale University School of Medicine, presented at the Radiological Society of North America's 2012 annual meeting, revealed that adding 3D tomography to mammography for screening purposes decreased recall rates by at least a third, particularly in younger women and those with more dense breast tissue. In fact, women with extremely dense breasts had an over 57% reduction in recalls when 3D tomography was added to conventional mammography.

The end result? For many women, especially younger women or those with dense breasts, adding 3D tomography will result in fewer false-positives and more cancers detected. ZPR now offers 3D tomography at eight of our nine locations. Ask your physician whether adding 3D tomography is appropriate for you.

For related blog topics, read Reducing Risk Factors for Breast Cancer, Resources for Women's Health,
10 Things You Should Know About Mammography and Dense Breast Tissue -- What Does it Mean?

Our February newsletter will cover what's new in breast imaging. If you do not receive our newsletter and you'd like to, you can sign up here.

All About Ultrasound

For the last few weeks, we've been answering some of the common questions people have about radiology, such as why is an MRI machine so noisy or what's the difference between digital X-ray and film X-ray or what is a "slice" in a CT scan? This week, we'll look at some common questions about ultrasound, also known as sonography.

What is ultrasound?
Ultrasound is a painless and safe test that uses high-frequency sound waves to allow healthcare practitioners to see organs, tissues and blood flow in the body.

Does it hurt?
Not at all! An ultrasound is painless and non-invasive.
Will I feel the sound waves?
No. The sound waves produced by an ultrasound can't be heard or felt.

Is there any radiation involved?
No. An ultrasound uses only sound waves, not radiation (like CT) or magnets (like MRI).

What is ultrasound useful for?
Ultrasound is routinely used during pregnancy to see the development of the baby, but  can also help evaluate internal organs (such as the heart, kidneys, liver, bladder, heart, thyroid, ovaries, and uterus) and blood flow.

Are there any adverse effects from having an ultrasound exam?
There are no known adverse effects from ultrasound. For that reason, you can safely have repeat scans.

Do you have any questions about MRI, CT, X-ray, Ultrasound or other scanning machines? Feel free to email us with your questions!

What is a "slice" in a CT scan?

For the last few weeks, we've been trying to answer some of the common questions people have about radiology, such as why is an MRI machine so noisy or what's the difference between digital X-ray and film X-ray. This week, we'll be talking about Computed Tomography (CT) scans.

In a nutshell, CT scanning, used to diagnose medical conditions, combines special X-ray equipment with sophisticated computers to produce multiple images of the inside of your body.

What is a "slice" in a CT scan?
 You may have heard that CT machines produce slices -- Zwanger-Pesiri Radiology has 64-slice, 128-slice, and 256-slice machines. But what does a "slice" mean? Well, it actually means exactly what it sounds like. Think of a slice of bread or a slice of cake -- the CT machine divides the body up into "slices" and takes pictures of these slices which are then reconstructed using a computer. The CT machine produces 2-dimensional pictures which are put together by a computer into very detailed, 3-dimensional images which show bones, soft tissue, organs, and blood vessels. These pictures then help physicians to diagnose problems. Imagine a loaf of bread. You can see the whole loaf at once or you can look at individual slices. CT gives doctors a very powerful tool to aid in the diagnosis of cancer, cardiovascular disease, infectious disease, appendicitis, trauma, and musculoskeletal disorders.

Are more slices always better? Do I always want to have the highest amount of slices possible?
That completely depends on what your physician is looking for. For some conditions, more slices are preferable and can help doctors identify very small abnormalities. For other conditions, the number of slices really doesn't matter. Your radiologist will know which choice is best for you.

What about radiation?
Zwanger-Pesiri is committed to keeping radiation doses as low as possible by using the newest technology. In addition, we participate in the Image Wisely program, which encourages smart medical imaging. We pledge to eliminate unnecessary scans and provide you with the safest scans possible. After your CT, the actual radiation dosage that you were exposed to will be printed on your records and will be provided to you. Keep this information as part of your personal medical record. 

Do you have any questions about MRI, CT, X-ray, Ultrasound or other scanning machines? Feel free to email us with your questions!

Film X-rays vs. Digital X-rays

Last week, we answered a question about why MRI machines are so loud. This week, we answer another commonly asked question: Is there a difference between film X-rays and digital X-rays, and does it matter?

The answer is yes, there is a difference (several actually) between digital and film X-rays, and those differences do matter. Here's why:

German physicist Wilhelm Conrad Röntgen is credited with discovering the X-ray in 1895. (Other scientists had observed the X-ray, but Röntgen was the first to really study it and imagine what it could be used for.) A few weeks after his discovery, Röntgen took the first human X-ray picture of his wife's hand (shown at left). Röntgen later won the first Nobel Prize in Physics for the X-ray.

The X-ray proved to be an invaluable tool for the medical profession, as it allowed physicians to see inside the body without surgery.

Originally, all X-rays used film to produce the images. Like the film you use in a camera, it had to be treated properly and images had to be developed in a darkroom. As technology developed, digital X-rays were introduced, using digital sensors rather than film, to produce images that are available immediately and need no development. Think of it as similar to camera technology -- cameras all used to use film to produce images. Now most cameras on the market are digital and produce digital images. You already know what the benefits of digital pictures over film pictures are: no sending film out to a lab for processing, clearer images that can be easily expanded, sharpened or tweaked, and the immediate satisfaction of not having to wait for your pictures. Plus, your pictures can easily be stored on your computer or in multiple places, unlike a negative which is easily lost or damaged.

The same applies to digital X-rays versus film X-rays.  Digital X-rays have some clear advantages over the old-fashioned use of film. For example:

• Digital X-rays expose patients to far less radiation than film X-rays, so they pose less of a health risk.
• The images produced by film X-ray are often less clear than digital, and this sometimes results in the need for a second round of X-rays, meaning more radiation.
• Digital images can easily be edited, enhanced, and quickly sent to a physician for a diagnosis. The earlier the diagnosis, the better the chance of effective treatment.
• Film X-rays require the use of hazardous chemicals for development, resulting in dangerous environmental waste.
• Images are immediately available with digital X-rays, but require time for development with film.

As you can see, not only are there significant differences between film and digital X-rays, but those differences really do make a difference. At Zwanger-Pesiri Radiology, we are committed to minimizing radiation exposure for patients and to providing patients with the best technology, which is why we ONLY use digital X-ray.

Do you have any questions about X-ray, Ultrasound, MRI, CT, or other scanning procedures? Feel free to email us with your questions!