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Looking for Answers Inside the Body
Diagnostic imaging refers
to the various tools used to look inside the
body for clues about a medical condition. A wide
variety of image technologies — X-rays,
computed tomography
(CT) scans, nuclear
medicine scans, magentic
resonance imaging (MRI) scans,
endo- and colonoscopes and ultrasound — are
available. While the technology used depends
on the patient's symptoms and the part
of the body being examined, the quality and accuracy
of the image lies with the skill and expertise
of the physician.
“Most hospitals have the latest imaging
equipment,” said Michael
H. Bleshman, MD,
vice chair of Penn's department of radiology, “but
they often do not have the experience in operation
and interpretation that is available at Penn
to glean the most from the technology."
A
History of Expertise |
Penn
has a long history of excellence
in imaging. Before the discovery
of X-rays in 1890, Penn professors
were experimenting with exposing
photographic plates to radiation.
The Hospital of the University of
Pennsylvania is home to the first
department of radiology in the United
States. |
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As a major academic medical center, Penn physicians
and researchers develop the technology and expand
its uses and teach the techniques to radiologists
across the country and around the world. Many imaging
technologies now in use were first developed
and/or perfected at Penn, including:
Breast MRI: Used in conjunction with
mammography, breast MRI can help identify breast
cancer at an earlier stage. A recent study helps
establish magnetic resonance imaging (MRI) as
a key component of the diagnostic workup for
women at the time of initial breast cancer diagnosis.
Penn's Abramson Cancer Center was one of
25 test sites for the study.
Endorectal coil MRI: Used in the diagnosis
of cancer, a balloon-covered coil is placed in
the area surrounding the prostate or cervix during
the MRI in order to develop high quality images
of the area surrounding the rectum and has shown
increased accuracy in diagnosing and evaluating
the extent of cancer.
Positron emission tomography or PET: Used
to detect cancer and changes throughout the body,
PET involves introducing a radioactive substance
into the body and taking pictures of how the
substance moves and is absorbed by various organs
and tissues. It can be used to determine blood
flow, the location of tumors and chemical activity
in the brain.
Medical care today often depends on the ability
to see inside the body quickly and accurately.
At Penn, the specialists interpreting the images
often work in just one field — such as
heart images, brain images or gastrointestinal
images. This expertise in a specific area results
in greater accuracy of the diagnosis. In addition,
this specialization also means Penn radiologists
are looking for more than anatomical changes
in the image.
“Most radiologists generally look at an
image for changes to the patient's anatomy,” said
Dr. Bleshman. “At Penn, we also look for
molecular changes. For instance, when studying
a brain MRI, in addition to looking for a tumor
we look at blood flow and other function of the
tissue surrounding the tumor. We can also examine
the chemical makeup of both the tissue and the
tumor to determine the best treatment to reach
a successful outcome before surgery.”
Alongside Penn's expertise in imaging, it also
has the latest technologic advances in imaging
equipment. The hospital now has seven MRI systems
dedicated to patient care and two additional
units used exclusively for research. The newest
patient care MRI suite contains three
state-of-the-art high powered MRIs.
One of the
systems is more open to easily accommodate large
patients or patients uncomfortable in enclosed
spaces. The special hardware and software of
the second unit send more frequent signals during
the scan, enabling it to capture a complete image
of a beating heart. The third MRI is a higher
resolution machine that creates sharper images,
particularly of the brain and bones. “This
combination of available technology allows us to
match the appropriate MRI technology to the specific
symptoms and needs of each patient,” said
Dr. Bleshman.
The
Latest Technologic Advances |
Three-dimensional
Brain Imaging:
Neurosurgeons and neuroradiologists
at Penn are using a device that merges
various images, such as CT and MRI,
into three-dimensional objects. When
viewed through stereoscopic goggles,
the result is a three-dimensional,
virtual reality image that can be used
in surgical evaluation and planning
as well as education. The image can
be manipulated to determine the surgical
path, measure distance and curve and
test the surgical approach. |
Dual-source
Heart Imaging:
Pioneering dual X-ray source,
multi-slice CT imaging technology
produces detailed, three-dimensional
images of the heart. Dual-sourced
means that two different X-ray
sources are used, and by comparing
the images physicians can differentiate,
characterize, isolate and distinguish
fluid, soft tissues and calcium.
The dual-source CT takes pictures
twice as fast as the older technology,
essentially “freezing” the
motion of the heart in the images. |
Endoscopic
Ultrasound:
Endoscopic ultrasound joins the capabilities
of the flexible endoscope with the
high resolution imaging of ultrasound
to produce gastrointestinal images
of unparalleled quality. Penn is
one of the most highly regarded centers
in the world for application of and
training in endoscopic ultrasound
for digestive diseases and related
disorders. |
Ultra-high
Field MRI:
In the fall of 2007, the latest in
MRI technology arrived at Penn. The
7 Tesla Whole-Body MRI, currently
being used for research purposes,
may be able to provide radiologists
with insights into structure, function
and physiology of the body. Tesla
is the measure of the strength of
the magnet used in the MRI. Most
diagnostic MRIs have a magnet strength
of 1.5 Tesla. Only a handful of the
ultra-high field scanners are in
operation. |
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Penn Radiology will be adding new, even more
advanced imaging technology with the opening
of the Perelman Center for
Advanced Medicine in 2008.
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