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Formerly known as X-ray or radiology, this department provides all of the diagnostic imaging for patients including: X-ray, Mammography, CT Scans, MRI, Ultrasound, Nuclear Medicine & Bone Density Testing. Most of these procedures are done on an outpatient basis at UnityPoint Health - Marshalltown Medical Park; however, a physician may order additional procedures during your hospitalization. Our certified technologists will explain your procedure, and we encourage you to ask questions at any time. Results of your procedure are read by a Board Certified Radiologist and reported directly to your personal or attending physician.
This hybrid technology combines the strengths of two well-established imaging modalities in one imaging session to more accurately diagnose and evaluate cancers while increasing patient comfort. A PET/CT scan is noninvasive, painless and takes about 30 minutes. Along with providing better imaging data, it notably increases patient comfort and convenience by reducing the number of scanning sessions a patient must undergo. The procedure is covered by private insurance and Medicare in most cases.
The new combined PET/CT machine allows physicians to rapidly perform both scans in one session without having to move the patient. This means physicians can precisely overlay the metabolic data of the PET scan and the detailed anatomic data of the CT scan to pinpoint the location and stage of tumors.
While PET/CT is primarily used in cancer diagnosis and evaluation, it also has applications in cardiology and brain imaging, and it will help UnityPoint Health - Marshalltown physicians better understand the workings of heart disease and such neurological disorders as epilepsy and Parkinson’s disease. UnityPoint Health - Marshalltown's state-of-the-art PET/CT scanner was manufactured by GE Medical Systems.
Computed Tomography (otherwise known as CT or "CAT" scanning) combines advanced computers and rotating x-rays to create highly detailed cross sectional computer generated images of body parts and internal organs in order to detect different disease processes. The exam is fast, patient-friendly and has the unique ability to detect and diagnose a wide variety of medical conditions and abnormalities. It is frequently used as the primary diagnostic tool for early detection of tumors, infection, inflammatory conditions, stroke, obstructions, trauma and kidney stones.
Why Is CT Performed?
CT can provide detailed cross-sectional images and diagnostic information for nearly every part of the body that cannot be provided by conventional x-ray studies:
What Can I Expect During a CT Examination?
If your examination is of the abdomen or pelvis, you will be asked to arrive two hours prior to your examination to drink oral contrast, which will allow for a better evaluation of the bowel.
Although many examinations do not require intravenous injection of contrast, in some cases it may be required to optimize your study. This will be discussed with you in detail by one of our staff members at the time of your visit.
When it is time for the exam, the patient is positioned by a technologist on the CT table. Once situated, the table moves through a doughnut shaped ring called a gantry. This allows the body part that is being studied to be "scouted" by electronic sensors and then viewed on a monitor. For many types of examinations you will be asked to hold your breath and remain still for a few moments. With our high-speed spiral ("helical") scanner, image acquisition is so rapid, that breath holding is usually 20 seconds or less. Most examinations are completed in 10 to 15 minutes.
Why Are Oral And Intravenous Contrast Used In CT?
Oral contrast is used to image the stomach and intestines. It is a very dilute, flavored barium solution that you drink approximately 2 hours prior to an examination.
Intravenous contrast is sometimes referred to as "dye". Although colorless, it contains iodine, which makes specific organs, blood vessels, and tissues visible on x-rays for better detection of disease or injury. It is not radioactive. We only use "non-ionic" contrast, which is formulated to minimize any risk of an allergic reaction. The risks and benefits of contrast will be explained to you when you arrive for your examination. Occasionally, mild allergic reactions may occur such as hives, rash or itching. In rare instances a patient may have a more severe allergic reaction, which might include difficulty breathing, swelling in the throat, or loss of consciousness. Our staff is fully trained and experienced to manage any potential adverse reaction.
Patients will be asked, and should notify our staff, if they have a history of allergy to IV contrast or iodine injections, diabetes, asthma, kidney disease, severe heart disease, multiple myeloma, sickle cell disease or if they are taking diabetic medication.
What If I Am Claustrophobic?
Because the CT is open at both ends (like a doughnut), most claustrophobic patients have little difficulty with the procedure. If you are severely claustrophobic, you might ask your doctor to consider a mild sedation.
When Will I Know The Results Of My Examination?
A Radiologist will review your study before you leave the hospital to determine if the information is complete. Results will be sent to your physician. Your physician will then call you to discuss the results. Urgent results will be telephoned immediately to your doctor.
What Should I Do to Prepare for a Computed Tomography (CT) Scan Exam?
Patients are encouraged to bring something to read in case there is an unexpected delay or emergency case. It is preferable that you wear comfortable, loose fitting clothing--like a shirt or blouse. You may be asked to remove any clothing or jewelry that might degrade the CT images, such as: belt buckles, earrings, bras, glasses, dentures and hairpins.
If your examination is of the abdomen or pelvis, you will be asked to arrive 2 hours prior to your examination to drink oral contrast to better evaluate the bowel.
For the following examinations, do not eat 4 hours before the test. However, please take your prescription medication, as you normally would, with clear liquids only.
For the following, no special preparation is needed:
Nuclear Medicine was developed in the 1950s. It is a branch of radiology that uses small amounts of radioactive isotopes to provide information about the functioning of organs and to treat disease. Information gathered by nuclear medicine procedures is more comprehensive than other imaging modalities because it shows function, not just structure, of organs. The heart, bones, thyroid, liver and many other organs can be imaged easily, and problems with their function revealed. Because these procedures generally require very small doses of radioisotopes, the radiation to the patient is often less than or equal to a standard x-ray. Nuclear medicine can be used to:
UnityPoint Health - Marshalltown installed 3D digital mammography in 2016, bringing the most advanced technology in the early detection of a disease that strikes one in eight women. 3D mammography (breast tomosynthesis digital mammography) takes nine exposures of the compressed breast to provide enhanced image clarity. In comparison to traditional 2D mammography, the new 3D technology allows radiologists to see through layers of breast tissue to better examine any areas of concern and help avoid the overlapping of images, which can obscure signs of cancer or lead to false positives.
Mammography is the best screening tool to find breast cancer at an early stage, when treatment is highly successful. A mammogram is a low dose x-ray of your breast that can detect many changes that are too small or too deep to feel. Mammograms are considered safe, quick and relatively painless. On average, mammography will detect about 80-90% of breast cancers in women without symptoms. Ultrasound is sometimes used to help the radiologist determine if the patient needs further testing.
The American Cancer Society recommends annual mammograms for women 40 years or older. Most women who undergo screening mammograms each year do not have breast cancer. About 5- 10% of women have abnormal or inclusive mammograms and will need further testing. In most cases, additional imaging or biopsy leads to a final interpretation of normal breast tissue.
UnityPoint Health - Marshalltown offers screening and diagnostic mammograms. A patient can call and schedule their own screening mammogram. We try to make the process as comfortable and convenient as possible.
Most insurance companies will pay for an annual screening mammogram. The Prevent Program is in place to provide mammograms to those without insurance. We don’t want anyone to go without a mammogram. If you don’t have insurance and you need a mammogram, please contact the UnityPoint Health - Marshalltown Foundation at (641) 753-2712, and ask about the Prevent program.
Stereotactic Breast Biopsy System is also available at UnityPoint Health - Marshalltown. When a patient has had an abnormal mammogram we are able to use this minimally invasive procedure to rule out or confirm the presence of breast cancer. The procedure takes less than one hour and the patient can get dressed and go home soon after the procedure is finished. In the past, the only way to rule out breast cancer after an abnormal mammogram was through a surgical biopsy. Surgical biopsies require the use of general anesthetic, an open incision, and the possibility of a scar (80% of all biopsies are negative). With the Stereotactic equipment, we can provide definitive answers, in most cases, without the need for a surgical procedure.
Ultrasound imaging, also called ultrasound scanning or sonography, involves exposing part of the body to high-frequency sound waves to produce pictures of the inside of the body. Ultrasound exams do not use ionizing radiation (x-ray). Because ultrasound images are captured in real-time, they can show the structure and movement of the body's internal organs, as well as blood flowing through blood vessels.
Ultrasound imaging is usually a painless medical test that helps physicians diagnose and treat medical conditions.
Ultrasound examinations can help to diagnose a variety of conditions and to assess organ damage following illness.
Ultrasound is a useful way of examining many of the body's internal organs, including but not limited to the:
Ultrasound is also used to:
What will I experience during and after the procedure?
Most ultrasound examinations are painless, fast and easy.
After you are positioned on the examination table, the radiologist or sonographer will spread some warm gel on your skin and then press the transducer against your body, moving it back and forth over the area of interest until the desired images are captured. Ultrasounds are generally painless and quick. If scanning is performed over an area of tenderness, you may feel pressure or minor pain from the procedure.
Ultrasound exams, in which the transducer is inserted into an opening of the body, may produce minimal discomfort and are only done if the physician orders it.
If a Doppler ultrasound study is performed, you may actually hear pulse-like sounds that change in pitch as the blood flow is monitored and measured.
Once the imaging is complete, the gel will be wiped off your skin.
After an ultrasound exam, you should be able to resume your normal activities.
Who interprets the results and how do I get them?
A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care or referring physician, who will share the results with you. In some cases, the radiologist may discuss preliminary results with you at the conclusion of your examination.
UnityPoint Health - Marshalltown installed the community’s first Open Bore, 1.5 Tesla, magnetic resonance imaging (MRI) system that combines a larger bore, or opening, for obese and claustrophobic patients with the ability to capture high-field quality diagnostic images.
The Siemens Medical Solutions MAGNETOM Espree available at UnityPoint Health - Marshalltown features a bore opening of nearly 2.3 feet in diameter and almost one foot of free space between a patient’s head and the magnet. The Espree also features the shortest 1.5 Tesla magnet available. Approximately four feet long, the magnet allows more than 60 percent of exams to be completed with the patient’s head outside the bore, helping to ease claustrophobia.
The new system provides up to four times more signal-to-noise ratio over traditional open MR designs, which is desirable in imaging larger patients. The MAGNETOM Espree provides best patient comfort and high-quality images and diagnostic confidence for all types of patients.
What Can I Expect During An MRI Examination?
A technologist will explain the MRI procedure to you when you arrive. You will be asked to remove and store any objects containing metal so that there is no interference with the magnet. These include coins, watches and other jewelry, hair clips, keys, credit cards, and dentures. Depending on the part of your body to be scanned, you may be asked to change into a gown. You will be asked to lie flat on a padded table. Some patients, but not all, need an injection of contrast as part of the MR examination. When the radiologist decides that contrast is necessary, a pharmaceutical agent, called Gadolinium is administered. The Gadolinium contrast is used to make specific organs, blood vessels, or tissues stand out. This helps highlight the structures to better assess for disease or injury.
If Gadolinium is necessary, a small needle (a butterfly) is inserted into a vein in the arm or hand, and removed immediately after the injection. As with any medication, there is a very slight chance of an allergic reaction. Side effects are very uncommon with Gadolinium.
During the exam you may hear a tapping noise. This is normal and is created when some of the parts of the magnet (the gradient coils) are turned on and off very rapidly to measure the MRI signal that comes from the patient’s body. The knocking may be loud enough to require ear plugs or head phones. During the examination, you will be able to listen to music through the headphones, and to communicate with the technologist at all times via intercom.
Only the portion of the body that is being imaged must be in the center of the magnet. For example if the head is being imaged, it must be in the magnet. If the knees are being imaged, they must be in the center.
You should try not to move when you are in the magnet, especially while you hear the knocking noise. It is particularly important that you not move the body part being imaged during the study. If you need to stretch a muscle, you may do so in between image acquisition, when the knocking noise has stopped.
You may talk to the technologist, via intercom, at any time during the study. It’s best to talk, however, in between the pictures, to minimize any motion.
At the UnityPoint Health - Marshalltown Diagnostic Imaging Center, we offer a wide array of examinations. Depending on the type of exam you receive, the length of the procedure will typically be between 30 to 60 minutes. The technologist will discuss the specifics of your exam, prior to your test.
When Will I Know The Results Of My Examination?
A detailed written report of the procedure, findings and results will be sent to your physician within several days. Your physician will then call you to discuss the results. Urgent results will be telephoned immediately to your doctor.
Bone densitometry is a non-surgical method of measuring bone density. Bone density (BMD) is a measurement used to estimate bone strength and the likelihood of bones to break (fracture) with simple trauma. Thus bone densitometry is a non-surgical method that can be used to assess fracture risk. However, it is only part of an overall assessment of fracture risk that your doctor or health care provider can perform.
A standard X-ray is not a good way to assess bone density. There are different techniques for measuring bone density. The currently accepted "gold standard" method is called "Dual Energy X-ray Absorptiometry" -- abbreviated DEXA.
Central DEXA is a non-surgical and painless examination consisting of a very low dose X-ray. Very low doses of X-ray (about 1/30 the radiation of a standard chest X-ray, less than radiation from an airplane trip, equivalent to two hours of direct sunshine) are used to rapidly scan your bones. A computer converts this information to numbers indicating your bone density. This is a high technology test that takes only a few minutes and involves no shots, needles, enemas or medicine. In fact, you don't even have to take off your clothes, provided what you are wearing does not contain any metal objects.
A central DEXA test measures bone mineral density (BMD) at the spine and/or hip and/or radius and sometimes the whole body. Central DEXA is generally considered the "gold standard" method of measuring BMD for diagnosing osteoporosis and monitoring the effects of osteoporosis therapy.
What should I expect at the time of BMD testing?
This depends on the type of bone density test you are having. However, all are non-surgical and involve a painless examination that does not involve injections or contrast materials. You will likely have to wear a gown and have your height and weight measured. The lumbar spine/hips, along with various other skeletal sites, are usually examined. The time it takes to perform these tests varies depending on a number of factors.
For central DEXA testing, you may be asked to wear a gown. You will need to lie on your back, on a table, in a comfortable position for several minutes. You should remain as still as possible during the procedure. Generally, you can resume your usual activities immediately.
A Radiologist will interpret your test results and send those results to your physician.
An x-ray (radiograph) is a painless medical test that helps physicians diagnose and treat medical conditions. Radiography involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.
A bone x-ray makes images of any bone in the body, including the hand, wrist, arm, foot, ankle, knee, leg or spine.
What will I experience during and after the x-ray procedure?
A bone x-ray examination itself is a painless procedure.
You may experience discomfort from the cool temperature in the examination room. You may also find holding still in a particular position and lying on the hard examination table uncomfortable, especially if you are injured. The technologist will assist you in finding the most comfortable position possible that still ensures x-ray image quality.
Who interprets the results and how do I get them?
A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care or referring physician, who will share the results with you.