Reasons for Callbacks

• Dense breasts. Dense breast tissue appears solid white on mammograms and may be more challenging to see through. In most cases, a 3D Screening Mammogram will see suspicious abnormalities that could be breast cancer, but additional imaging may be recommended on a case-by-case basis.
• Difference in priors. Your most recent Screening Mammogram may show changes when compared to prior imaging and additional images may be recommended to see more clearly what those changes are. 
• Abnormality. If something appears suspicious, additional imaging or a biopsy of that area may be needed.
• Clarity issue. The use of lotions, antiperspirants, powders, or other products around the breast area can appear on imaging and look like an abnormality. In these cases, it is essential to re-take the image so the radiologist can get a clearer reading.

What Comes Next

The majority of findings in abnormal mammograms are benign, but because early detection can save lives, it is vital to have them checked as soon as possible. In most cases, if you are called back after a screening mammogram, additional imaging will be recommended. Typical imaging recommended:

• Diagnostic Mammogram
• Ultrasound
• Biopsy

How To Prepare 

Once you have additional imaging scheduled, there is not much that you need to do. However, if you are nervous, prepare a list of questions to ask your doctor. They will be able to answer them. If you have had imaging done previously at another facility, make sure that your radiologist has them. They will be able to compare, which helps get a fuller, detailed view of what is going on.

At Delaney Radiology, our team of radiologists, clinical staff, and administrative team is here for you to answer questions and help you with your needs. Don’t hesitate to reach out if you need help understanding your mammogram report or why you were called back after a screening. We will get you the answers you need.

Sources

mayoclinic.org

cancer.org

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FAQ For The Layman Crew

What is MRI? Magnetic Resonance Imaging (MRI) is a machine that uses strong magnets to take detailed pictures of the body. These images help doctors see details inside the body that differ from other Radiology scans (X-Rays, CT scans, or ultrasounds).

What is 3T MRI? The “T” used in describing MRI systems refers to the strength of the magnetic field. The “T” is short for Tesla, a unit describing magnet strength. Most medical MRI systems are either 1.5T or 3T. Some open or mobile MRI systems may have lower strength than 1.5T. For comparison, a small bar magnet has a strength of 0.01T. Strong magnets are necessary to create the detailed images in MRI.

What is the benefit of 3T MRI? 3T MRI (3Tesla MRI) shares many of the same benefits of 1.5T MRI. The detailed images from MRI can answer important questions and guide a doctor’s care for you. In general, MRI uses no radiation like X-Rays and CT scans. In many instances, 1.5T and 3T imaging are comparable for your medical care.

The higher strength of a 3T magnet does provide some additional benefits compared to weaker magnets. Specifically, higher detailed imaging is possible that may be harder to see with a 1.5T MRI. Small organs (such as the prostate gland) and small structures (such as ligaments or tendons in the hand) are better seen with a 3T system than others.

Because of the nature of how MRI images are made, patients have to lie still for long periods of time to get high quality pictures. 3T MRI has the benefit of cutting down scan times compared to other weaker magnets. Additionally, 3T MRI often has a wider tube (like the Delaney 3T MRI system), which can provide a better imaging experience, especially for larger patients and patients with claustrophobia. “Open MRI” systems do exist for these patients as well; however, those are usually weaker magnets with lower image quality compared to a “closed MRI”.

What is the added cost of 3T MRI? Insurance companies do not distinguish 3T MRI from other MRIs at the same location. The cost is the same to you for all the extra details 3T MRI images provide.

Shouldn’t everyone get a 3T MRI? 1.5T MRI is still considered standard of care to answer many medical care questions. 3T MRI has many benefits but it is not for everyone. 

Patients with certain medical devices or surgical implants (joint replacements, screws, clips) may be safely imaged at 1.5T but not necessarily in the stronger 3T MRI. Rest assured, our capable staff at Delaney Radiology will review your medical history and tailor your MRI to ensure your safety.

Because of how the images are made, MRIs of certain body parts (like the abdomen – including liver, pancreas, kidneys) can sometimes look better on a 1.5T MRI than a 3T MRI. Our staff will ensure your MRI is performed on the proper magnet to get the best images possible for your care.

FAQ For The Clinical Crew

What is 3T MRI? MRI systems in general use strong magnets to create minor separations in the energy of protons (hydrogen atoms) in the body. Radiofrequency pulses are then used to manipulate those protons and generate images based on their microenvironments. MRI protocols are set up to highlight disease states. For example, one set of MRI images may have water protons appear white on the image and another set of MRI images may have water appear dark on the image. IV contrast is often given to provide additional details on disease states.

What is the benefit of 3T MRI? In general, 3T MRI provides better imaging options than lower strength magnets. The added strength of the 3T magnet can be leveraged to provide thinner cut (1mm) images with high level detail or generate image quality similar to a 1.5T system in less time. Optimization of one or both of the above factors is patient-specific and disease-specific.

3T MRI provides an incremental benefit in most indications for MRI. It is specifically recommended by certain medical societies (i.e. PI-RADS ACR guidelines recommend 3T MRI for prostate cancer). 3T can provide higher quality imaging of small structures such as ligaments, tendons, cranial nerves, and small blood vessels (MR Angiogram).

The larger bore 3T MRI tube used at Delaney means a better patient experience with less risk of claustrophobia and potentially less need for sedating drugs. Larger patients will feel more comfortable in the wider tube system without having to sacrifice image quality on a lower strength (open) MRI. 

Can I specifically order a 3T MRI? 1.5T is still standard of care for many disease states, but we will attempt to accommodate specific requests for 3T MRI. Our Subspecialty-trained Radiologists have developed a triaging system for “appropriate for 1.5T”, “should be 3T”, etc. That being said, there are certain instances when 3T MRI is not feasible or even safe.

Patients with certain medical devices or surgical implants (joint replacements, screws, clips) may be safely imaged at 1.5T but not necessarily in the stronger 3T MRI. Our technical staff will gather details on device and patient histories to make certain your patients can be safely imaged at one system or the other.

Because of how the images are made, MRIs of certain body parts (like the abdomen – including liver, pancreas, kidneys) can look better on a 1.5T MRI than a 3T MRI. This is especially noticeable in obese patients or patients with ascites. 

For the above reasons, we ask that you would allow us to triage patients to our 1.5T system or 3T system based on established technical and medical reasoning. If you believe a patient class is being incorrectly imaged at 1.5T, we ask that you engage with our Subspecialty-trained Radiologists to ensure our triaging is up to date with your respective society’s guidelines. 

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You and your heart have one life together! Foster that bond and get the most out of your life together by adding more heart healthy things to your lifestyle. Every step counts, and a little bit goes a long way!

Here are 9 steps you can take towards a healthier heart:

1. Stop or decrease the amount you smoke or vape. Your risk of heart attack or stroke reduces the moment you quit.
2. Move your body more. Physical activity can reduce your risk of a heart attack. Even small changes to your activity level can
3. Manage your stress. Stress is known to have a huge impact on your heart. Find ways to decrease stress in your life or learn to manage it by creating calmness like practicing yoga, meditation and focusing on deep, consistent breathing.
4. Only drink alcohol in moderation. Heavy drinking increases cholesterol and triglycerides which is linked to increased risk of heart attack and stroke. It can also increase blood pressure and lead to weight gain.
5. Get a good night’s sleep. The lack of sleep could result in high blood pressure. Work towards 7-8 hours of restful sleep each night.
6. Eat healthier. Increasing healthy foods like vegetables, fruits, good proteins and whole grains along with decreasing your intake of salty, fatty, sugary and processed foods can go a long way to improving your health and your heart.
7. Stay up to date with regular well-visits with your doctor. Developing a baseline with your doctor helps them to know when something abnormal is going on. Detecting problems early, means that there is a higher chance of treating the issue.
8. Maintain a healthy body weight. Knowing your BMI and setting goals to achieve a healthy weight with your doctor can decrease your risk of heart disease.
9. Control your cholesterol and blood pressure. Cholesterol causes strain on your heart, resulting in high blood pressure and potentially heart disease. By following steps 1-9, you are already doing your part to keep your cholesterol down. Lowering your cholesterol and high blood pressure by not smoking, getting enough physical activity, being less stressed, limiting alcohol, getting restful sleep, eating a balanced diet, talking to your doctor and maintaining a healthy weight are great steps to controlling your cholesterol and blood pressure. This gets you on the right path to a healthier heart.

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MYTH: Finding a lump means you have breast cancer.

FACT: Only a small percentage of lumps are actually breast cancer. Most lumps are felt with hormonal changes and shouldn’t be of concern.

MYTH: Using antiperspirant causes cancer.

FACT: There is no scientific evidence linking breast cancer to deodorants and antiperspirants. However, some studies have found that women who use aluminum products under their arms are more likely to have higher concentrations of aluminum in breast tissue.

MYTH: I won’t get breast cancer if I don’t have a family history of it.

FACT: 90-95% of those diagnosed have no family history of breast cancer.

MYTH: Men do not get breast cancer.

FACT: 2,400 male breast cancer cases are diagnosed annually. Anyone with breast tissue can develop breast cancer.

MYTH: Mammograms can cause cancer to form or spread.

FACT: Mammograms emit a very small dose of radiation, and the benefits of early detection far exceed any associated risks. 

MYTH: Breast cancer always causes a lump you can feel.

FACT: Not all breast cancers cause a lump and can not always be felt.

MYTH: All breast cancer is treated the same way.

FACT: Each person’s treatment plan is different and is based on the patient and the diagnosis.

MYTH: You can’t get a mammogram screening if you have breast implants.

FACT: Mammograms are still recommended, even if you have breast implants. Most breast implants are designed to withstand hundreds of pounds of pressure and it is unlikely for them to rupture. However, implants can obscure findings on images so it is important to inform your technologist of implants as they know how to work around this by moving the implant and taking more images.

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Uterine fibroids are benign growths, developed from muscle tissue, found in and on the uterus. Usually found in women in their 30s and 40s, before menopause, but can occur at any age. Although fibroids are very common, much is left unknown about their cause and people often have misconceptions regarding them. In this blog, we will expose some of these misconceptions and spread some light on uterine fibroids and what you need to know.

1.   MISCONCEPTION: FIBROIDS ARE CANCEROUS

Due to the fact that fibroids are found around the uterus, many people assume that they are cancerous and connected to uterine cancer. This is a misconception. Fibroids are not cancerous. Fibroids are benign growths and are not connected to uterine cancer. They are typically not life threatening, but may cause pain or other symptoms.

2.   MISCONCEPTION: FIBROIDS CAUSE PAIN AND MUST BE REMOVED

When someone finds out that they have fibroids, they often think the growths MUST be removed. This is not always the case. Some women live with uterine fibroids and do not know it. Some are so small that they are undetectable by the human eye. Because fibroids vary in size, it is common for them to be unsystematic and not cause any pain. Some women do not realize they have them unless they are spotted in a routine exam or ultrasound.

Common symptoms of uterine fibroids include:

• Heavy or prolonged periods
• Bleeding between periods
• Abdominal discomfort and/or fullness
• Pelvic pain
• Lower back pain
• Bladder symptoms, such as frequent urination or difficulty emptying the bladder
• Bowel symptoms, such as constipation or excessive straining with bowel movements

3.   MISCONCEPTION: FIBROIDS ARE ONLY FOUND IN AFRICAN AMERICAN WOMEN

Fibroids can be found in women of any age, race, shape and size. However, African American women are more likely to have fibroids than any other racial group. These fibroids are also usually larger and cause more problematic symptoms.

Much is left unknown about uterine fibroids when it comes to causes and risk factors, and keeping a healthy weight, balanced diet and normal blood pressure decreases your risk of developing them. The below are common risk factors associated with Fibroids:

• Race. Although race is not necessarily known to be a factor in the development of uterine fibroids, research has concluded that African American women developed them more than any other race.
• Age. Typically, women of child bearing years are more susceptible to uterine fibroids, however women of an age can develop them.
• Genetics. Fibroids can be hereditary. 
• Hormones. High estrogen levels and low progesterone can lead to the development and growth of fibroids.

4.     MISCONCEPTION: FIBROIDS CAUSE INFERTILITY

Uterine fibroids are very common and many women with small, unsystematic fibroids can get pregnant naturally. However, certain types of fibroids have been seen in women experiencing infertility issues.

5.     MISCONCEPTION: UTERINE FIBROIDS CAN’T BE TREATED

In some cases, uterine fibroids do not need treatment and because some are very small, they may not continue to grow. However, for those that cause pain or are very large, there are several treatment options available for those experiencing uterine fibroid symptoms, some of these include:

• Hysterectomy. Once thought to be the only treatment option for uterine fibroids, there are now more treatments available, but a hysterectomy may be an option.
• Uterine Fibroid Embolization (UFE). UFE is a minimally invasive treatment option where fluoroscopy is used to guide embolic agents to the uterus and fibroids. The agents block arteries and provide blood to the fibroids, causing them to shrink. 
• Hormone Treatments. Increased levels of hormones can cause fibroids to grow. Lessening your body’s estrogen and increasing progesterone can help to shrink fibroids.
• Myomectomy. These are non-invasive procedures that remove the fibroids without damaging the uterus. There are several types of the procedure. Some include: Hysteroscopy, Laparoscopy and Laparotomy
• Radiofrequency Ablation (RFA). This procedure uses heat to destroy tissue. This treatment is used for long-term pain management.

Fibroids are typically found during pelvic exams. Further testing may be required to diagnose uterine fibroids. These tests include:

• Ultrasound
• Lab Tests
• Magnetic Resonance Imaging (MRI)
• Hysterosonography
• Hysterosalpingography
• Hysteroscopy

If you experience any symptoms or have a family history of uterine fibroids, speak to your doctor. If your doctor suspects fibroids, they may complete further testing. If you are diagnosed with uterine fibroids, you may have treatment options available. 

Sources:

The Mayo Clinic

John Hopkins Medicine

Fibroid Institute Dallas

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This is still hard for me to admit sometimes, so I’ll just come right out and say it: I’m turning 40! It’s hard to really put into words how I feel about this milestone. On one hand, I’m at a point in my life where I’m now living many of the dreams I had when I was younger: I have a very satisfying and rewarding career as a radiologist, I have a wonderful family with a supportive husband and 3 beautiful children. So many things to be thankful for! On the other hand – HOW AM I 40?!?!?! I can no longer claim adolescent ignorance due to lack of life experience and some people may consider me to be “over the hill.” I’ve even caught myself saying “music just isn’t what it used to be.” What was once popular and cutting edge in my 20’s is now considered “throwback” and “vintage.” It’s just hard for me to wrap my head around it – I’M 40!!!! 

But it’s also exciting, turning 40. My kids are getting older and becoming more and more independent, which means I get to spend more time with my husband and doing the things I love. I’ve learned to embrace change and be grateful for the time I’ve been given. If I’ve learned anything after living through hurricanes, natural disasters, wars, terrorist attacks, stock market crashes, political scandals and especially a global pandemic, it’s that life is short. And because I’d like to have another 40+ years, I need to make sure I take care of myself. Being the type A personality I am, I start to plan – how will my life change when I turn 40?

I know that I need to schedule my annual physical and get the “40 work up.” I know it will include blood work, advanced questions about my health, and of course my first screening mammogram. As a radiologist, I help women everyday screen for and diagnose breast cancer, but now it’s my turn. What they say is true – physicians really are the worst patients. Nevertheless, I will lead by example and schedule my screening mammogram.  I will also talk to my doctor about other screening exams like virtual colonoscopy, CT lung screening, and heart calcium scoring. Thankfully, I know I can get it all done at Delaney Radiology. 

Yes, I work at Delaney, so of course I’m slightly partial, but I also KNOW the people who work at Delaney, not only physicians, but also technologists and staff, and they are all genuinely wonderful people who want to take the best care of our patients that we can.  I see first hand when they take the time to walk an elderly patient to their car or even console them when they receive bad news. But don’t take it from me…all you have to do is Google us and look at our reviews to see what people really think about us. So I’m grateful to have Delaney as a resource to guide me through this new chapter of my life. 

And what do you know – Delaney is turning 40 too! It’s wonderful to know there is still an independent practice here in Wilmington that has been around for 40 years and helped possibly millions of people. Even over just the last six years of my tenure with Delaney, I have seen incredible change in the health care landscape. It has also been wonderful watching and being a part of how Delaney has grown and adapted to whatever has come its way. 

So Happy 40th to me. Happy 40th to my fellow 1982-ers! And Happy 40th to Delaney Radiology. May we all be around for 40 more!  

To schedule your screening mammogram or other screening exam, call Delaney Radiology at (910) 762-3882 or request an appointment here.

*A doctor’s referral may be required

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The US Preventive Services Task Force and radiology societies are now recommending this annual screening exam for people meeting the following criteria:

• 50-80 years old AND
• Have smoked at least 20 pack-years (i.e. one pack/day for 20 years) AND
• Currently smoke OR have quit smoking within the last 15 years

This recommendation is a recent change in criteria in part to capture more African American patients who are at increased risk for developing lung cancer with a shorter smoking history than other racial groups.

It is important to note that the Centers for Medicare and Medicaid Services currently only cover this exam for those 50-77 years old with a 20 pack-year history. CMS is now taking open public comments for consideration, and there are possible insurance coverage changes happening in the future to reflect these new recommendations.

*Update 7/23/21 – BlueCross, Cigna and Aetna recently updated their guidelines to reflect these new recommendations.

So, if you or someone you love meets the qualifications for this screening exam, we want you to understand why it is so important. Here are our top 5 reasons to get a CT lung cancer screening every year.

1. Lung cancer is the #1 cause of cancer death among men and women in the U.S.

Lung cancer is the most common cancer worldwide, and it impacts minorities at even higher rates. Don’t allow yourself to fall victim to a statistic. If you’re at high risk, or think you might be, don’t wait any longer for a CT Lung Cancer Screening. Talk to your doctor, check with your insurance provider, and give our office a call to schedule your exam. Having these conversations now is worth a lifetime of health in the future.

2. Early detection is the biggest factor for survival

Unfortunately, patients with early lung cancers often have no symptoms (things like weight loss or difficulty breathing). Once there are symptoms, lung cancer is often more advanced and survival rates are lower. This is why early detection is so crucial. According to the American Lung Association, lung cancer screening exams are shown to reduce lung cancer deaths by 14-20% among high-risk populations by finding the disease at an earlier, more treatable stage.

3. A CT Lung Cancer Screening is a painless, fast, accurate test for identification of early lung cancers

Besides lung cancer, this CT screening exam detects other smoking-related conditions like COPD and vascular disease. These diseases can directly impact the quality of your life so why not treat them sooner rather than later? An hour of your day could save your life.

4. Simple exam involves no needles and no contrast injection

Similar to getting a chest X-ray, the lung cancer screening CT is performed with a few breath holds. However, CT provides much more detail and allows radiologists to find smaller lung nodules. By simply laying on a table and letting the machine do all the work, you could be adding years to your life.

5. Designed to be low radiation exposure

We all encounter radiation every day. A CT lung cancer screening exam is equal to about 6 months of normal radiation exposure from soil and the sun. As with all of our imaging exams, we take every necessary precaution to ensure patient safety and limit the radiation exposure. It is always important to remember that the potential for life-saving early detection far outweighs any risk of limited radiation exposure.

As you can see, getting a CT lung cancer screening exam every year is a simple task that offers undeniable benefits to patients who are at high risk. There are many more reasons why taking control of your health and having screening exams are important, but we hope these five reasons will help you to make the best decision for your health in the future.

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Did you know that the adult human body has 206 bones? This means there are a lot of things that would require musculoskeletal imaging or image-guided procedures to diagnose and treat pain. Our fellowship-trained MSK physicians specialize in diagnosing and treating diseases and injuries of the musculoskeletal system.

MSK Disorders

Musculoskeletal disorders are conditions that can affect your muscles, bones, and joints. Some conditions that might require MSK imaging and image-guided procedures include (but are not limited to):

• Tendinitis
• Arthritis
• Osteoporosis
• Plantar fasciitis
• Sports injuries
• Fractures

These things could be caused by lifting heavy weights, repetitive motions and even your age, occupation, or family history.

Exams and Procedures

At Delaney Radiology, we offer a wide range of imaging services and image-guided procedures. Our providers perform several types of minimally invasive, image-guided radiology procedures for specialized diagnostic or treatment purposes. The following exams and procedures are used to diagnose and/or treat musculoskeletal disorders and injuries:

• Arthrogram – This starts with an x-ray guided injection of anesthetic and contrast agent into the joint of interest. After the injection, a CT or MRI is performed to better visualize the internal anatomy of the joint for more accurate diagnosis and surgical planning. Our providers perform arthrograms of multiple joints including the shoulder, hip, wrist, and knee.
• Steroid Injections
  • Therapeutic Joint Injection – In a procedure that has both diagnostic and pain management purposes, a provider injects an anesthetic and steroid into the joint. The response to the injection determines whether the targeted joint is the cause of the pain, while also providing temporary pain relief that can last from hours to months.
  • Facet Injection – In this procedure a precise injection of anesthetic and steroid is administered into the small joints of the back for pain relief. Often, multiple injections are performed at different segments to identify which segments are generating pain. The procedure is very important for precise diagnosis and treatment of neck and low back pain.
  • Spinal Injection – Several procedures can be performed to diagnose and treat pain arising from the lower back, including epidural injections and selective nerve root blocks. In these procedures, imaging is used to guide a needle into the space around the nerves in order to inject an anesthetic and/or steroid to ease pain and reduce inflammation. Pain relief can last several months and be repeated multiple times per year as necessary.
• Joint Aspiration – This is a special procedure used to remove fluid from a joint helping to diagnose the cause of the fluid and provide relief from pressure and pain.
• MSK Ultrasonography (ultrasound) –  In this exam, diagnostic images of the soft tissues, through the use of high frequency sound waves, will be obtained. This ultrasound has a variety of uses including diagnosing tendon or ligament tears, inflammation, soft tissue masses or fluid within the joints. The exam is most commonly utilized on the shoulder, knee, Achilles tendon, and foot. You can always trust our expertise as these exams are performed solely by our MSK radiologists and sonographers, all of whom are proficient and expertly trained in MSK ultrasound.

For more information on our image-guided radiology procedures visit our special procedures page.

If you are suffering from joint pain, please talk to your doctor to determine if one of these procedures might be right for you. Always remember that you have a choice in your health care and can request to have your imaging and image-guided procedures performed at Delaney Radiology. Our staff of board-certified radiologists, physician assistants and trained technologists will ensure your imaging is high quality and cost effective every time. We want to help ease your pain and get you back to doing the things you love most.

To learn more about our Fellowship-Trained MSK Radiologists and Physician Assistants, visit our provider page.

Sources:
Healthline
Hopkins Medicine

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That’s how much you could save by choosing us for your imaging needs.

With more patients shouldering higher deductibles and copays, out-of-pocket healthcare costs are an increasing concern. So next time you need a diagnostic test, choose Delaney Radiology. We’re committed to providing world-class imaging services at a value price—often saving you hundreds or even more.

We understand that healthcare insurance, deductibles and out-of-pockets costs are super confusing and we’re here to help you make educated decisions about your healthcare.

For more information read the 4 part “Price Transparency Blog Series” on the ACR Bulletin website.

Call our billing department at (910) 763-1800 for more cost saving information.

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