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Patient Care > Diagnosis

Imaging Scans

Patient Care > Diagnosis

Imaging Scans

Subang Jaya Medical Centre uses a variety of tests and procedures to diagnose cancer. Your age, the type and stage of your disease, and the results of previous tests will determine the type of test you need. Patients may need to undergo one or more tests (investigations) to determine the most appropriate course of treatment.

Computed Tomography (CT) Scan

CT scans are diagnostic imaging tests that produce detailed images of internal organs, bones, soft tissues, and blood vessels. During a CT scan, cross-sectional images can be reformatted in multiple planes and generated in three dimensions. A CT scan is often the preferred method for detecting many different types of cancer. This is because the images allow your doctor to confirm the tumour’s presence and determine its size and location. As well as monitoring tumour growth, it can assess a patient's response to cancer treatment.

  • How Dual Source technology is revolutionising CT scanning at SJMC

    With a dual-source CT scanner, two X-ray sources and two detectors are used to create high-quality diagnostic images of a patient's beating heart and coronary vessels without artificially lowering their heart rate. Additionally, the system produces consistent image quality at low doses by eliminating breathing and motion artefacts when scanning children or trauma cases. It is also capable of screening for lung cancer.

    In most cases, lung cancer is diagnosed at an advanced stage when surgical treatment is not an option. Low-dose CT (LDCT) screening is essential to fighting lung cancer. This is according to a study of more than 53,000 men and women in the United States with a history of heavy smoking. Participants screened with LDCT had a 20 percent lower risk of dying from lung cancer than those in a control group who received standard chest X-rays. The reduction in mortality can likely be attributed to earlier detection and treatment of tumours.

    A low-dose CT screening image was taken using SJMC's Somatom Drive CT scanner. The dose given to the patient was approximately 20-27 times that of a chest X-ray. This dose is at least 80% lower than a standard chest CT scan.

  • SJMC installed AIRO: Mobile Intraoperative CT, the first in a Malaysian private hospital

    AIRO is designed to fit inside existing operating rooms and offers an integrated and versatile CT imaging and patient positioning solution. Cranial, spine, and trauma procedures are performed using AIRO.

    Providing CT imaging in the operating room increases surgeon confidence during surgery and provides accurate image guidance to plan the surgical path and make informed decisions.

    Its user-friendly control software allows it to be operated by a single individual. A front-facing safety camera ensures stress-free portability. Adaptable to various procedural setups, AIRO can be used in cranial, spine, and trauma surgery cases.

    Additionally, AIRO is connected to CURVE, an image-guided surgery system, enabling quick and automatic image transfer and the fusion of preoperative and intraoperative images.

    As a result of the installation at SJMC, it is the first time such a service is available in Malaysia’s private hospitals. This is to improve patient care.

  • Hybrid Angio CT in Interventional Radiology

    Plan, treat, and verify in one room using one system. A single solution that integrates into an interventional laboratory eliminates the need for patients to be transferred between different rooms. In addition, it contributes to additional speed, safety and effectiveness of complex interventions.

    Interventional Radiology procedures include Angioplasty and Stent Insertion, TransArterial Chemoembolization (TACE), Radiofrequency Ablation, Cryotherapy, Venous Access, and Varicose Vein Ablation.

    Interventional radiology can treat liver cancer, liver metastases, lung cancer, and kidney cancer.

    There are many advantages to the Hybrid Angio CT, such as crystal clear and versatile imaging, high image quality, and advanced options for image visualisation and processing.

General X-Ray

General x-ray uses low dose x-rays to produce pictures of the body's internal structures. X-rays are the oldest and most frequently used form of medical imaging. An x-ray may detect a tumour in an organ such as the lung, diagnose fractured bones, look for an injury or infection, and locate foreign objects in soft tissue.

HSG (hysterosalpingography)

HSG is an x-ray test used to examine reproductive organs. This can assist in diagnosing the cause of your inability to become pregnant. In the procedure, a radiologist (a doctor specialising in using x-rays) takes images while a contrast dye flows through the uterus and fallopian tubes. It usually takes less than 30 minutes to perform an HSG. In most cases, you will be able to return to your routine within a few days.

  • Getting Ready For HSG

    The procedure will be scheduled shortly after the end of your menstrual period. When you plan for your test, tell the staff if you have allergies to iodine contrast.

    You may be asked to provide a list of your medications. After the procedure, you can arrange for a ride home. You may be prescribed antibiotics before and after the test.

    The healthcare provider may ask you to do the following a day or two before the examination:

    • Do not engage in sexual activity
    • Do not use creams or other vaginal medications
    • It is recommended that you avoid douching
    • A few hours before the test, you may wish to take over-the-counter pain medications
    • During HSG

    The procedure involves lying on an x-ray table with your knees bent, similar to a Pap smear. You may be required to undergo a preliminary X-ray of your pelvis. The vagina is held open by an instrument known as a speculum. There is the possibility of numbing the cervix. In the next step, a catheter (a thin tube) is guided through the cervix and into the uterus. In some cases, the cervix may be dilated first to widen the cervical opening.

    An X-ray machine will be placed over your abdomen by the radiologist. A contrast dye is then injected through the catheter. There may be some cramping or pain associated with the dye due to stretching the uterus and tubes. A monitor displays x-rays as the dye flows through the uterus and tubes.

    Additionally, you may be asked to change positions and hold your breath. Some dye may spill out of the tubes and be absorbed by the body. The rest of the discharge may appear later as vaginal discharge.

  • After the Procedure

    You can rest on the table until you are ready to get dressed if you feel lightheaded or dizzy.

    As some of the dye drains from the uterus, you may experience a thick discharge. It would be best to use pads rather than tampons until the discharge is cleared. Before you leave, you will be provided with a pad.

    There may be some cramping for a few hours following the procedure. The pain can usually be relieved with over-the-counter pain medications that your physician approves. For a few days, you may be instructed not to engage in sexual activity or use the bathroom.

  • Follow-Up

    Your doctor will discuss the results of your HSG with you after the radiologist has analysed the x-rays. It may occur later that same day or during a follow-up appointment.

Magnetic Resonance Imaging (MRI Scan)

A magnetic resonance imaging (MRI) test uses a powerful magnetic field, radio frequency, and a computer to obtain cross-sectional images of organs, soft tissues, bones, and other internal body structures. The device is used to evaluate a variety of conditions, including the detection of tumours. MRI produces images of the human body by utilising protons and magnetic fields.

In 2003, two scientists from the United Kingdom were awarded the Nobel Prize for their contribution to the development of magnetic resonance imaging (MRI), which is capable of imaging the internal organs and functioning of the body without using X-rays. MRI is now an essential diagnostic tool for imaging many parts of the body purely based on changes in the vibration of protons inside powerful magnetic fields. With the recent upgrade of the 3T MRI to a digital platform, SJMC's MRI services have been enhanced. Due to the upgrade, patients and doctors will enjoy better image quality and shorter imaging times.

SJMC’s newly upgraded 3T digital MRI

For many patients, preparing for an MRI exam can be a daunting experience. In some cases, patients may be asked to remove jewellery, credit cards and to provide detailed information about all the metallic instruments inside their bodies. Also, patients are forced to lie on a table that is placed into a barely large hole to accommodate a person. They are subjected to loud noises while remaining perfectly still. SJMC's radiographers and nurses are available to prepare and care for patients and ensure that the images produced are of the highest quality. MRI services at SJMC have grown from one to two advanced MRI systems capable of scanning for detailed anatomical and functional information to assist physicians in diagnosing patients.

Digital Mammography

In digital mammography, low-dose x-rays detect breast cancer early, before women experience symptoms.

  • 3d Mammograms Improves Breast Cancer Screening - SJMC’s Tomosynthesis Service

A 3D mammogram, more commonly known as Digital Breast Tomosynthesis, was approved by the FDA in 2011. Since then, many studies have demonstrated the benefits of this novel technology and its potential role in improving breast cancer screening.

To provide high-quality breast screening & diagnostic services to the community, SJMC installed the latest Hologic Selenia Tomosynthesis system in the Mediplex Health Screening Centre in early March 2020.

For many years, the digital mammogram in 2D has been a valuable tool for screening breast cancer, but it has certain limitations. There is evidence that Digital Breast Tomosynthesis can resolve issues associated with Digital Mammograms. These issues include the high incidence of false positives and false negatives and the low number of cancers detected. Digital breast tomosynthesis has the following advantages:

  • Improved patient comfort by reducing breast compression and applying less pressure-just enough to maintain breast stability during the procedure
  • Toto obtains clear, focused 3D images throughout the breast; multiple x-rays are taken from various angles in an arc around the breast
  • A scan time of 3.7 seconds provides superior patient comfort and a lower patient dose since 2D X-ray exposures have been eliminated. Using special software, the system produces high-quality 2D images derived from tomosynthesis data.
  • An improved cancer detection rate, especially among Asian women with dense breast tissue.

A screening recommendation for the general population (MOH Clinical Practice Guidelines: Management of Breast Cancer, 2nd Edition, Nov 2010):

  • In women between the ages of 50 and 74, mammography should be performed biennially (Grade A)
  • Women aged 40 to 49 years of low and intermediate risk should not be routinely screened for breast cancer using mammography (Grade A)
  • It is not appropriate to deny mammography screening to women aged 40 - 49 years if they desire it (Grade C)
  • It is recommended that Breast Self-Exam (BSE) is used to raise awareness among women at risk rather than as a screening method (Grade C)

Ultrasound

Ultrasound is a non-invasive method of obtaining images of organs and tissues. Furthermore, imaging guidance is helpful during needle biopsies and for assessing conditions related to blood flow.

Sonography, or diagnostic medical sonography, is a method of imaging that uses high-frequency sound waves to produce images of structures inside the body. Various diseases and conditions can be diagnosed and treated using these images.

The majority of ultrasound examinations are performed with the use of an ultrasound device outside the body. However, some examinations involve the placement of an ultrasound device inside the body.

  • Getting Ready for Ultrasound

    The majority of ultrasound exams do not require any preparation. There are, however, a few exceptions:

    Before some scans, such as a gallbladder ultrasound, your doctor may ask that you refrain from eating or drinking for up to six hours.

    In some instances, such as a pelvic ultrasound, it may be necessary to have a full bladder. You may need to drink up to six glasses of water two hours before the exam and not urinate until the test has been completed.

    There may be additional preparation required for young children. Ask your doctor if there are any specific instructions you need to follow when scheduling an ultrasound for yourself or your child.

  • Clothing and Personal Items

    You should wear loose clothing to your ultrasound appointment. During your ultrasound, you may be asked to remove jewellery, so you should leave all valuables at home.

  • Before The Procedure

    In preparation for your ultrasound, you may be asked to do the following:

    • Make sure that all jewellery is removed from the area being examined
    • You may wish to remove some or all of your clothing
    • You should change into a gown
    • Toto perform the examination, you will be required to lie on a table
  • During The Procedure

    During the examination, a gel is applied to your skin. As a result, air pockets are prevented from forming, which may prevent sound waves from generating images. Removing this water-based gel from the skin and, if necessary, from clothing is easy.

    During the procedure, a technician (sonographer) or radiologist presses a hand-held device (transducer) against the studied area and moves it as necessary to capture images.

    Ultrasounds are sometimes performed inside the body. This transducer is attached to a probe inserted into your body's natural opening.

  • Results

    Following your examination, a radiologist (a physician trained to interpret imaging studies) analyses the images and sends a report to your physician. You will be informed of the results by your physician.

    Once you arrive at the Imaging department, you may have to wait 2-3 hours for the ultrasound to be completed and for your report to be generated.