Hôtel-Dieu Grace Hospital - Diagnostic Imaging

Hôtel-Dieu Grace Hospital is home to one of Canada’s leading Diagnostic Imaging programs. The department provides a complete range of imaging procedures to support the hospital’s key programs: Complex Trauma, Renal Dialysis, Acute Mental Health, Stroke and Neurosurgical and Cardiology, as well as regional programs such as the Windsor Regional Cancer Centre. Services provided include General X-ray, Fluoroscopy, Interventional and Special Procedures, CT, MRI Ultrasound and Digital Mammography.

The Department occupies 20,000 square feet within the Diagnostic and Treatment wing of the hospital, making HDGH the largest provider of imaging services in the Erie St. Clair LHIN. In 2005/2006, the department performed 149,737 exams.

HDGH is actively moving towards refreshing all of its existing imaging modalities including the acquisition of a 64 Slice-CT Scanner and our new Angioplasty Suite with three-dimensional rotational road mapping. The equipment for the Angioplasty Suite is expected to be installed by March 2007. The remainder of the equipment is expected to be replaced over the next 5 years, according to the 5 year capital plan.

Regional PACS throughout the Enterprise

HDGH, WRH and LDMH all contribute to a Regional PACS system providing clinicians in the area a single access point to view patient images from any of the three hospitals.

HDGH offers patients state-of-the-art imaging and equipment and facilities, setting the standard for quality care in Canada.

Two general radiology rooms, one specifically outfitted for Trauma
Two digital fluoro rooms for gastric and tomographic procedures
Six GE ultrasound machines
One panorex
One digital chest room with additional grid for small parts
One digital mammography machine with stereotactic biopsy capability
One mammotone
One 1.5 Tesla Siemens Avanto MR with advanced processing
One 64-Slice Siemens Sensation CT with advanced processing and one Dual Source CT Siemens Sensation
Two Angiography suites
Two C-arms in the Operating Roon
All digital imaging uses KODAK CR
Multiple portable units throughout the building

HDGH BREAST CENTRE

Most breast disease is benign and the non-surgical confirmation of this is a welcome option.

Our Centre is accredited by the Canadian Association of Radiologists (CAR) and the Ontario Breast Screening Program offers a range of services related to breast health and breast-related illness including:

Mammography: Screening and Diagnostic
Breast Ultrasound
Stereotactic Mammotome Core Biopsies
Mammotome Core Biopsies performed under Ultrasound
Galactography—Ductography
Pre-operative Stereotactic Localization for Open Biopsy
Ultrasound Guided Localization
Fine Needle Aspiration Cytology of palliable Mass under Ultrasound
Specimen Radiography
Sentnal Node Imaging in Conjuction with Nuclear Medicine

Modality Overview

CT / CAT SCAN

HDGH operates 2 CT scanners, which in turn results in a very short waiting list for CT procedures. CT stands for Computed Tomography. It is a computerized x-ray machine that examines the body. The scanner is comprised of a table and a gantry. The gantry is the donut shaped part that houses the x-ray source. The x-ray source rotates inside the gantry as the patient moves through. Data is obtained and processed by a computer to produce a two dimensional image.

GENERAL RADIOGRAPHY - RADIATION SAFETY

Pregnancy is the only contraindication to plain x-ray. If you are pregnant or think you may be pregnant, please inform the technologist. An assessment can be made of your specific situation to determine any risk to an unborn child. If it is decided that the possibility of pregnancy is too high, you may be asked to come back at a later date for your x-ray examination. Although you are being exposed to ionizing radiation, your physician has weighed the benefits of the information obtained from your procedure, against the risk of ill-effects from the radiation you receive and knows that the benefits far outweigh the risks.

Your technologist has been well trained and is bound by standards of practice to keep your radiation dose as low as reasonably achievable. Technology has also allowed us to provide optimum results while minimizing your exposure. Sometimes extra views of an area may be needed to better demonstrate anatomy or pathology. Your technologist will ensure that each view is diagnostic and that no view is wasted.

MAMMOGRAPHY

A mammogram is a safe test used to look for any problems with a woman's breasts. The test uses a special, low-dose x-ray machine to take pictures of both breasts. The results are recorded digitally onto a computer for a radiologist to examine. Mammograms allow the doctor to have a closer look for breast lumps and changes in breast tissue. They can show small lumps or growths that a doctor or woman may not be able to feel when doing a clinical breast exam.

"Mammography" is the best screening tool that doctors have for finding breast cancer. If a lump is found, your doctor may order other tests, such as ultrasound or a biopsy, a test where a small amount of tissue is taken from the lump and area around the lump. The tissue is sent to a lab to look for cancer or for changes that increase the risk of cancer. Breast lumps or growths can be benign (not cancer) or malignant (cancer). Finding cancer early means a woman has a better chance of surviving the disease. There are also more choices for treatment when breast cancer is found early.

MRI

Magnetic Resonance Imaging (MRI) is a painless non-invasive diagnostic procedure that allows the physician to see detailed images of the internal structures of your body without using x-rays. Your body is composed of small particles called atoms. Hydrogen atoms, i.e. in water, make up 95% of the body. Normally, these hydrogen atoms within your body spin around at random. However, when you are placed inside a strong magnetic field, the hydrogen atoms line up and spin in the same direction as the magnetic field. When a radio wave is transmitted through the body, the hydrogen atoms give off a signal. That signal, with the aid of a computer, becomes the source of MRI information to produce two-dimensional images or three-dimensional volumes of a part of your body.

MRI scans illustrate more clearly than ever before possible, the difference between healthy and diseased tissue and can provide important information MRI can lead to early detection and treatment of disease and has no known side effects. Consequently, your physician will be better able to determine the most appropriate treatment for you.

BASIC MR SAFETY

MRI uses radio-frequency pulses and strong magnetic field to produce Diagnostic Image. Gadolinium based contrast is used for IV enhancement. Proper precautions are necessary to ensure patient safety. The following Ferro-Magnetic and electronic items are contra-indicated for MR. Inadvertent entry of patient, family member, hospital personal is managed through a 3 part screening process to avoid patient injury.

1. Cardiac pacemaker is an absolute contra-indication.
2. Defunct pacemaker lines are relative contra-indication.
3. Non-MR compatible aneurysmal clips are absolute contra-indication. When the make and model of the aneurysmal clip is not known, this should be considered non-MR compatible.
4. Implanted and imbedded metallic foreign body and prosthesis are relative contra-indications. For example, certain otologic implants, certain ocular implants, imbedded neuromuscular stimulator, intra-vascular coils, filters or stents less than 6 weeks old, certain types of catheters, ports and pumps are contra-indicated. Some types of penile prosthesis and soft tissue expanders including breast implants are also contra-indicated. Some implants may be scanned safely but may result in artifact.

NUCLEAR MEDICINE

Nuclear Medicine is a branch of medicine and medical imaging that uses the nuclear properties of matter in the diagnosis of disease processes and for therapeutic treatments. Patients will receive a small amount of a radioactive material either by injection, inhalation or by swallowing a capsule. It will not make them sick: just highlight the area to be imaged. Images are obtained on a gamma camera that the patient lies under. You cannot feel anything while the images are being taken but it is important for the patient to lie still to produce the best quality images for the Nuclear Medicine Physician to read.

The images are reviewed and the results sent to the patient's doctor.
Nuclear Medicine procedures are very safe. The amount of radiation you receive from a Nuclear Medicine test is about the same as you would get from a diagnostic x-ray. The radiopharmaceutical administered does not contain any dyes and is less likely to cause reactions. A radiopharmaceutical or tracer is a specially designed compound that is bound to a radioactive material. These tracers are designed to act like natural products in your body. Nuclear Medicine tests look at how the body is functioning.

SPECIAL PROCEDURES AND ANGIOGRAPHY

Angiography is the study of blood vessels and organs by injecting contrast media (x-ray dye) into arteries or veins and taking pictures as the contrast media flows through these blood vessels. For certain disease processes, we are able to offer treatment in the angiography suite rather than sending our patients to the operating rooms. This group of procedures is termed "interventional procedures". The angiography department has two new angiography rooms for body angiography, neuron-diagnostic and interventional procedures. Our angiography team consists of interventional radiologists, specially trained in the field, medical radiation technologists and nurses.

ULTRASOUND

The department provides service to many programs within the hospital along with providing additional support to outside services. A full spectrum of exams is performed including general ultrasound imaging as well as ultrasound guided treatment options such as injections. The programs supported by the department include neurology, stroke management, kidney disease, kidney transplant workup, carotid stent placement, trauma, out patient clinics and deep vein thrombosis investigation.

A variety of exams and procedures related to women’s imaging are also done including breast and pelvis scanning. Sonohysterography is a procedure used for investigation of the uterus and to investigate infertility.
Historically ultrasound imaging has been used as a diagnostic tool to assist in answering a question regarding the health of the patient.

Today the diagnostic capability has expanded with the use of ultrasound guided biopsies. An example of the biopsies done include breast, thyroid, liver, pancreas, spleen, kidney and chest. The biopsy procedures done with ultrasound guidance are easily tolerated by the patient and provide a quick and relatively simple way of answering the question. Ultrasound imaging also includes treatment options such as guided injections of shoulders and hips that are done to alleviate painful symptoms.