State-of-the-Art Women’s Imaging
Monday, May 30, 2011
University Radiology Associates, LLP in Syracuse, NY, is pleased to bring positron emission mammography (PEM) to the Central New York area.
Photo: University Radiology Associates, LLP utilizes the region’s only 3-Tesla MRI scanner.
Affiliated with State University of New York (SUNY) Upstate Medical University, University Radiology Associates, LLP offers a wide range of imaging services designed specifically for women, including breast MRI, digital mammography, bone-density studies, ultrasound-guided breast biopsies and stereotactic breast biopsies. The addition of PEM rounds out the available options, allowing the practice to provide all-inclusive imaging care.
Understanding PEM
PEM methodology is similar to positron emission tomography (PET), as it also involves administering the radiolabeled marker fluorine-18 deoxyglucose (FDG), usually by intravenous injection, to more easily observe how the body metabolizes glucose. Because tissues are very active in metabolizing glucose — with malignant tumors usually metabolizing glucose at a higher rate than benign tumors or normal tissues — physicians can more easily distinguish abnormal tissues that warrant concern, identifying cancerous breast lesions with increased precision and accuracy. PEM can also be used for the performance of breast biopsy. Through direct observation, guiding physicians can pinpoint the lesion demonstrating the highest level of metabolic activity.
“PEM is a successful technique for observing tissues’ metabolic activity because the human body cannot distinguish between radiolabeled glucose and normal glucose,” says David Feiglin, M.D., Director of Nuclear Medicine Imaging at University Radiology Associates, LLP and professor and Chair of the Department of Radiology at SUNY Upstate Medical University. “If a metabolically active breast cancer is present, the FDG will promptly be taken up by the lesion of concern and will appear as ‘hot spots’ on our imaging screen. This machinery is an advanced piece of equipment, and we are very excited to bring this technology to our patients.”
Compared to breast MRI, mammography and ultrasound, PEM provides both increased sensitivity and the ability to quantitate the metabolic activity of a suspected breast lesion — features not available with these other modalities.
Appropriate Candidates
According to Dr. Feiglin, PEM technology is not indicated for all patients. Rather, it should only be used to aid diagnosis in cases of uncertainty — particularly following routine X-ray mammography — and to aid physicians in the determination of the most appropriate treatment course for breast cancer patients or to monitor the success of administered cancer therapies.
“For the majority of women, mammography or ultrasound is sufficient,” says Dr. Feiglin. “In select patients, it may be difficult to interpret the findings of other breast-imaging techniques and to determine if a suspicious lesion is most likely benign or malignant. By using PEM to identify lesions that exhibit high levels of metabolic activity, physicians can make more informed diagnoses and treatment decisions. For example, use of PEM may help determine whether patients can avoid breast surgery or whether more intensive surgical interventions may be necessary.”
Because PEM is indicated for only a select group of patients, physicians are encouraged to refer possible candidates for PEM through the Breast Cancer Program at Upstate University Hospital.
Additional Services
PET technology is available to aid in the diagnosis of other types of cancers and to assist in monitoring tumor response to therapies, such as radiation therapy and chemotherapy. At University Radiology Associates, LLP, physicians also use PET technology for enhanced diagnosis of cardiovascular disease and neurological diseases, including dementia and Alzheimer’s disease, and to more easily monitor seizures. The most advanced PET-CT scanner in the region has just recently been added at SUNY Upstate Medical University and will be operated by University Radiology Associates.
In addition, University Radiology Associates, LLP provides access to the region’s only 3-Tesla MRI scanner, which allows physicians to obtain critically clearer images than can be acquired on any of the lower magnetic-field strength scanners in the region — especially useful in the diagnostic areas of breast, brain and body magnetic resonance imaging. Advanced CT scanning and ultrasound capabilities are available in conjunction with Upstate University Hospital, as well. The most advanced 320-slice CT scanner, which can perform CT imaging of the brain, heart and body with low radiation doses and in times ranging from less than one second to a few seconds, will be added to the arsenal of diagnostic imaging equipment operated by University Radiology Associates, LLP later in the year.
Committed to Excellence
All radiologists on staff at University Radiology Associates, LLP, are board-certified radiologists who have certificates of advanced qualifications in their chosen areas of imaging subspecialty, which include abdominal imaging, nuclear medicine, thoracic imaging, musculoskeletal imaging, vascular and interventional radiology, neuroradiology and women’s imaging.
“Our practice is divided into subspecialty services, which differs from many private radiology offices, where radiologists may do a little bit of everything without specializing in any one specific area,” says Dr. Feiglin. “Because each of our radiologists has subspecialty training, using his or her knowledge for teaching students, residents and fellows as part of their academic practice, patients receive a very high level of care and can rest assured that the physician performing their imaging studies has increased knowledge in that specific field of imaging.”
For more information about the services provided through University Radiology Associates, LLP, visit www.ura.com.
University Radiology Associates, LLP
MD News May/June 2011, Central New York