What is Women's Imaging?

Northeast Radiology has several radiologists with expertise in Women's Imaging. Women's Imaging includes imaging of the breasts, female pelvis, and bones to assess the bone density. Diseases assessed in Women's Imaging may occur as a result of trauma, infection, cancer or may be present on a congenital basis (congenital diseases are those a patient is born with). Diseases assessed in Women's imaging may be imaged using a variety of radiologic exams.

There are many modalities that can be used to image the breasts, female pelvis and bone density:
These include:

Mammography:

Screening and diagnostic mammograms are performed at Bethesda North Hospital located at 10500 Montgomery Road in Cincinnati. Screening mammograms are performed from 8am to 5pm Monday to Friday and 8am to 2 pm on Saturday. Diagnostic mammograms are performed Monday-Friday, 8:30 am-noon and 1 pm -4 pm at the hospital. Screening mammograms are also performed at Medi- Center North and Bethesda Arrow Springs 8am-5pm Monday-Friday. Diagnostic mammography is not available at these two facilities. You may or may not need a prescription to schedule your screening mammogram-please contact your insurance provider for further information. All diagnostic mammograms require a prescription. Your screening or diagnostic mammogram can be scheduled at our facilities by calling Central Scheduling at 569-6777.

Breast Ultrasound:

Breast ultrasounds are performed at Bethesda North Hospital, Monday to Friday 8am-4pm. All breast ultrasounds require a prescription from your doctor. These exams may be scheduled through Central Scheduling by calling 569-6777.

Pelvic Ultrasound:

Pelvic ultrasounds are performed at Bethesda North Hospital, Bethesda Arrow Springs, and MediCenter North Diagnostic Center. These exams are performed at the hospital 8am-4pm Monday to Friday and 8am-2pm on Saturday. 8am-4pm Monday-Friday at Bethesda Arrow Springs & MediCenter North Diagnostic Center. All pelvic ultrasounds require a prescription from a referring physician. These exams can be scheduled at our facilities by calling Central Scheduling at 569-6777.

Ultrasound guided breast biopsy, Stereotactic breast biopsy, MRI guided breast biopsy, Galactograms, Hysterosonograms:

These procedures are all performed at Bethesda North Hospital, Mon-Fri 8am-4pm. All breast biopsies require a prescription from your doctor and may require pre-certification from your insurance company. These procedures can be scheduled by calling Central Scheduling at 569-6777.

Breast MRI:

Breast MRI's are performed at Bethesda North Hospital and MediCenter North Diagnostic Center. These exams are performed Monday-Friday 8am-5pm. These exams require a prescription from your doctor and most insurance companies require pre-certification. These exams can be scheduled by calling Central Scheduling at 569-6777.

Bone Densitometry:

Bone density exams are performed at Bethesda North Hospital and Bethesda Arrow Springs. These exams are performed 8am-3pm Monday-Friday and 8am-3pm on Saturday at Bethesda North Hospital and 8am-3pm at Bethesda Arrow Springs. To schedule your exam, you will need a prescription from your doctor. Please call Central Scheduling at 569-6777.

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My doctor ordered a Mammogram. What is a screening mammogram? What is a diagnostic mammogram?

A mammogram is a type of x-ray test that uses a low dose of x-rays to examine the breasts. This exam is used to aid in the diagnosis of benign and malignant breast disease in women. A mammogram is a painless exam that will help the radiologist diagnose your breast condition.

A screening mammogram is an effective screening tool used to detect early breast cancer in a woman who is asymptomatic, (not experiencing any symptoms such as a breast lump, nipple discharge, pain or skin changes).

A diagnostic mammogram is a problem-solving mammogram used to evaluate a patient with an abnormal physical exam with findings such as a breast lump, nipple discharge or skin changes. A diagnostic mammogram may also be recommended after an abnormal screening exam to determine the cause of the area of concern on the screening exam.

You should prepare for your mammogram by :

• Obtaining any prior mammograms and making them available to the radiologist at the time of your current exam.
• Avoiding deodorant, talcum powder and lotion under your arms or on your breasts the day of your exam as these substances can mimic calcium spots on your mammogram.
• Describing any breast symptoms or problems to the technologist who is performing your exam

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My doctor and/or radiologist ordered a Breast ultrasound. What is this exam? What are the common uses of this procedure? How should I prepare for this procedure?

Ultrasound imaging of the breast utilizes sound waves. There is no ionizing radiation involved in breast ultrasound. The sound waves used in breast ultrasound are reflected off the internal organs. The reflections are then recoded by special instruments that create an image of normal and abnormal breast tissue.

Breast ultrasound is commonly used to :

• Determine the nature of a breast abnormality palpated (felt) on physical exam, to aid in determining if that breast abnormality is a benign fluid-filled lesion as a cyst or a solid mass as benign or malignant tumor.
• To further assess an abnormality detected on a screening exam, to determine if that abnormality is a cyst, solid mass, or normal breast tissue.

You will be asked to prepare for your breast ultrasound by undressing from the waist up and putting on a medical gown.

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What is a Pelvic Sonogram? What are the common uses of this procedure? How should I prepare for this exam?

Ultrasound imaging of the pelvis utilizes sound waves. There is no ionizing radiation involved in this exam. The sound waves used are reflected off the internal organs of the pelvis and are then recorded by instruments that create an image of normal and abnormal pelvic structures.

Pelvic sonography is commonly used to assess the uterus, cervix, endometrial canal and ovaries.  The pelvic sonogram images enable the radiologist to determine if these structures are normal or abnormal and if abnormal, why.

To prepare for your pelvic sonogram, you will be asked to come to the hospital with a full bladder and to undress from the waist down and put on a medical gown.

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What is a Hysterosonogram? What are the common uses of this procedure? How should I prepare for this exam?

Ultrasound imaging is performed using high frequency sound waves to produce pictures of the inside of the body.  Ionizing radiation is not used in ultrasound. Hysterosonography is a minimally invasive procedure that provides ultrasound pictures of the inside of a woman's birth canal. The exam is performed by injecting sterile saline into the birth canal, the endometrial canal. The saline outlines the canal and allows for easy visualization of the dimensions of the canal and any abnormal masses.  Ultrasound is used to record images of the endometrial canal and its contents. 

The exam is a valuable tool to aid in the evaluation of unexplained vaginal bleeding that may be secondary to:  masses as polyps, fibroids, tumors, or adhesions (scarring).

To prepare for this exam, you should wear loose fitting comfortable clothing.

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What is an Ultrasound Guided Breast Biopsy? How is it performed? What are some common uses of this procedure?

An ultrasound guided breast biopsy is a highly accurate way to evaluate suspicious masses within the breast that are visible on ultrasound.  The procedure avoids the need to surgically remove the mass.  After placing the ultrasound probe over the area of abnormality detected at ultrasound, and after using local anesthesia and ultrasound guidance, the radiologist directs a biopsy needle directly into the mass.  Tissue specimens are then taken using an automatic biopsy gun.  The specimens are then sent to the pathology department for microscopic assessment.  The exam results are interpreted by the pathologist.  The exam results are sent to the radiologist and referring physician generally within 48-72 hours.  The radiologist and/or referring physician communicates the exam results to the patient.

You will be asked to stop taking all blood thinners, i.e. coumadin, aspirin, Plavix, heparin etc for at least 48-72 hours prior to the procedure.  Immediately prior to the procedure, you will be asked to undress from the waist up and put on a medical gown.

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What is a Stereotactic Breast Biopsy? How is it performed? What are some common uses of this procedure?

Mammography is able to detect breast abnormalities, but in many cases is unable to determine if the abnormalities are benign or malignant.  In these indeterminate cases, a biopsy is necessary.  Stereotactic biopsy is an alternative to open surgical biopsy.  Stereotactic biopsy is a mammographically guided biopsy which uses a special computerized mammography machine to pinpoint the area of tissue abnormality.  Once the area of abnormality is detected by this machine, a biopsy instrument containing a needle called a vacuum assisted device is used. This device is inserted into the breast and multiple needle biopsies are performed through this device.  The biopsy specimens are sent to the laboratory for assessment by the pathologist. The pathologist evaluates the specimen and issues a report in 48-72 hours. Exam results are communicated to the patient and/or referring physician by the radiologist.

You will be asked to stop taking all blood thinners, ie coumadin, aspirin, Plavix, heparin etc for at least 48-72 hours prior to your biopsy.  Immediately prior to the biopsy, you will be asked to undress from the waist up and put on a medical gown.

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What is a MRI Guided Breast Biopsy? How is it performed? What are some common uses for this procedure? How should I prepare for this procedure?

Breast MRI is used as a problem solver in patients with abnormal mammograms and/or ultrasounds,newly diagnosed breast cancer patients and as an adjunct to more closely monitor patients at higher risk for developing breast cancer.  Some suspicious abnormalities that can be detected at breast MRI, may not be seen at mammography or breast ultrasound. These abnormalities may be indeterminate and biopsy may be indicated. Breast MRI may be performed as an alternative to open surgical biopsy in these patients.  In MRI guided breast biopsy, magnetic waves are used to help guide the radiologist's instruments to the suspicious area. The procedure is much less invasive than open surgical biopsy, requires only a local anesthetic and can usually be performed in less than an hour. Tissue samples obtained at the time of the biopsy are sent to the laboratory to be assessed by the pathologist.  Exam results are usually available to the radiologist in 48-72 hours.  The radiologist communicates the exam results to the patient and/or referring physician.

You will be asked to stop taking all blood thinners, i.e. heparin, coumadin, Plavix, aspirin, etc for at least 48-72 hours prior to your biopsy.  The day of your biopsy, you will be asked to undress from the waist up and put on a medical gown.

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What is a Galactogram ? What are some common uses for this procedure? How should I prepare for this procedure?

Galactography is an x-ray examination that uses low dose x-rays and a contrast material to examine the breasts and to obtain pictures of the milk ducts of the breasts (most cancers begin within the milk ducts of the breasts).  This exam is almost exclusively used to evaluate women with active bloody or clear nipple discharge. The exam is performed to assess the duct that is actively discharging, to determine if a mass, as a tumor, is present within a discharging duct and responsible for the nipple discharge.  Once x-ray dye has been injected into the discharging duct, x-rays are taken and assessed by the radiologist to determine if a mass (tumor) is present.  If a tumor mass is present, surgical excision of the tumor will usually be recommended.

Very little preparation is necessary for this procedure.  The only requirement is active discharge from the nipple at the time of the procedure.  If there is a history of allergy to contrast material, this information should be shared with the radiologist/technologist at the time of the procedure.  As in mammography, do not wear deodorant, talcum powder or lotion under your arms or on your breasts the day of the exam as these substances can mimic calcium spots on your mammogram.

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What is Breast MRI? What are some common uses of this procedure? How should I prepare for the procedure?

Magnetic resonance imaging is a non-invasive way of looking inside the body without the use of ionizing radiation but with a magnetic field and radio waves.  Together with a computer, these radio waves and magnetic field help create three-dimensional pictures of the head and body.  These detailed images allow radiologists to better evaluate parts of the body.

MRI of the breast is used to:

• evaluate indeterminate abnormalities seen on mammograms and ultrasounds
• identify early breast cancers in high risk patients
• screen for cancer in women with breast implants that limit assessment of native breast parenchyma
• determine the integrity of breast implants
• distinguish between scar and recurrent tumors
• check the progress of chemotherapy
• look for multiple tumors in patients contemplating breast conversation surgery
• determine true extent of cancers detected at mammography or ultrasound, prior to definitive surgery

There is little preparation required for breast MRI.  Patients who are in the first trimester of pregnancy, who have pacemakers, and have certain medical or electronic devices or foreign bodies may not be candidates for the procedure.

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What is Bone Densitometry? What are some common uses of this procedure? How should I prepare for the procedure?

Bone density scanning, bone densitometry, is an x-ray exam used to measure bone loss. It is a painless exam that helps physicians diagnose and treat bone loss.  Bone density is most often measured in the lower spine and hips.  

Bone density is most often used to diagnose osteoporosis, a condition that most often affects post menopausal women.  The exam can also be used to track treatment for osteoporosis and can also assess an individual's risk for developing fractures. 

You should avoid taking calcium supplements for 24 hours prior to the exam.  Loose clothing should be worn the day of the exam and garments that have zippers, belts or buttons made of metal should be avoided.  You may be asked to remove some of your garments prior to the exam and wear a medical gown.

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