Imagine the process of undergoing a radiological study. You visit your physician, who orders a study to evaluate a complaint or to screen for a disease. Either you or your doctor's office makes an appointment, and you arrive at the imaging center for your exam. At the imaging center, the front desk staff takes your information, alerts the technologist, and leads you to the scanner. The technologist reviews your prescription, discusses your history, and checks your lab studies. He or she then prepares you for the exam, positions you in the scanner, and performs the study. Then quality control is performed and the study is sent to the radiologist for interpretation. You are then returned to the front desk area so you can leave the center.
Allow us to provide some provocative questions to consider when you undergo your next imaging test:
- Were you scheduled at the right center? Sometimes being scanned on the same scanner or same manufacturer of scanner is important to ensure reproducibility of results (e.g., DEXA bone densitometry). Were you able to be scheduled for the exact test requested?
- Did the front desk make sure to identify you correctly and match you to your prescription? Did they make sure the exam was correctly requested and authorized and that you will not be billed inappropriately?
- Was your privacy and confidentiality respected?
- Did the technologist elicit an adequate history, making sure you did not have renal insufficiency (before receiving contrast) or a history of allergies?
- Did your technologist triage any potential questions by calling the radiologist? Maybe the exam did not seem like quite the right test. Maybe contrast would be helpful. Maybe delayed images would provide more clarity.
- Was the scanner a recent model? Does it have high-end technology that allows it to produce better, faster, or clearer images? Does it have the best radiation-reducing hardware available? For example, CT scanners come in single slice, 4-slice, 16-slice, and 64-slice models. MRI machines come in field strengths of 1.5T and 3.0T. "Low-field" MRI units come in much lower strengths (0.1 to 0.7 Tesla), meaning longer imaging time in the magnet and much lower quality images. Ultrasound machines range from low-end handheld models to high-end versions with all the bells and whistles.
- Does the scanner have all the right accessories? In ultrasound machines, you can have a larger, more varied selection of transducers to tailor the exam to the patient. We have special very high frequency linear transducers for musculoskeletal applications, as well as a selection of curved transducers to best suit patients with abdominal conditions. Similarly, in MRI you can have specific accessory coils that are tailored for the exam. We have a 32-channel cardiac coil for high-quality cardiac MRI. We have joint-specific coils like elbow and knee coils. We have special hardware to allow breast MRI in the prone position. Other providers might have a good machine, but are they using a general purpose, lower resolution coil to image a small body part?
- the scanner have the latest software? Often, while the hardware might be good, new software updates are needed to provide the best images or to lower the radiation dose.
- Are the protocols optimized and streamlined? Radiology machines are not one-button devices--you have to design protocols, tailored for individuals, disease processes, body parts, and many other considerations. We have literally hundreds of protocols that have been painstakingly created to best fit your situation. We have special protocols that range from low-dose CT for congenital heart disease patients to low-fat, high-muscle protocols for NFL players on a 3.0 Tesla magnet, and everything in between. Your computer probably doesn't have the same settings as when you bought it, and probably you adjusted your TV so it is not at factory settings -- would you want a CT scanner down the corner to scan you without having fine-tuned and perfected the protocols? Some providers might short-change you by running the fewest sequences possible; we image each patient thoroughly and make sure we have all the images necessary for your diagnosis.
- Did the technologist choose the right protocol, apply it correctly, troubleshoot artifacts, and ensure good image quality? Even with the best protocol uploaded to the machine, if the technologist is not diligent about noticing artifacts, compensating for breathing motion, and troubleshooting the scan, the study will not come out with diagnostic quality. Often the technologist must place saturation bands on MRI, perform additional images with ultrasonography or nuclear medicine, or add delayed images on CT, for example. And if you are not positioned correctly for any radiological study, the images just will not come out correctly either.
- Were you scanned safely? Our MRI technologists make sure you are comfortable throughout your scan, with special "call buttons" so you can alert us to discomfort. Our CT, nuclear, and X-ray technologists make sure your radiation dose is as low as possible. We have shielding available, when appropriate, ear protection, and MRI-safe medical equipment.
RASF can answer all these questions for you. YES. Through Baptist Health of South Florida facilities, RASF offers the latest technology, the most up-to-date software, and the best technologists and center staff we could ask for. We have exclusively 1.5 and 3.0T MRI machines, the latest gamma cameras and PET scanners for nuclear medicine, 16 and 64 slice CT scanners, andthe latest ultrasound and fluoroscopy equipment. The software is updated as quickly as possible, and we are proud to have ASIR (Adaptive Statistical Iterative Reconstruction) software on all our CT scanners, as well as GE Dose Check to make sure the lowest dose possible was given.
We have software updates on all MRI machines as well as a wide array of MRI coils tailored for specific body parts. We have a large selection of ultrasound transducers. We provide many specialized examinations other groups do not, including breast MRI, CT colonography, Coronary CT angiography, Cardiac CT calcium score, MR angiography, Endorectal MR coils, PET mammography, defecography, and many others. Our fluoroscopy equipment is state-of-the-art, with dose-lowering approaches, anti-leakage protection. Our radiation equipment is maintained by a medical physicist to ensure its quality and safety.
Not only is our diagnostic technology superb, but we boast one of the best interventional groups in the world. Through Baptist Cardiac & Vascular Institute (BCVI), South MIami Hospital, and Doctor's Hospital, we provide the very latest in endovascular therapy. Our Miami Vascular Specialists team is world-renowned; an innovative group led by interventional pioneers Dr. Barry Katzen and Dr. Jim Benenati, the group hosts the annual International Symposium on Endovascular Therapy (ISET), which is a conference attended by the world's best interventionalists to learn about new techniques and new understandings of disease, often developed here at RASF and BCVI. The founder of BCVI, Dr. Katzen engineered our breathtaking endovascular therapy suite of angiography rooms on the 3rd floor of the BCVI building. Walled in glass, they symbolize both the transparency of the high-quality work that is performed there as well as our ability to see through your soft tissues into your vessels and organs and not only diagnose your condition, but also treat it. The fluoroscopy, CT, and ultrasound devices used to visualize the targets of therapy are on the cutting edge of technology. A state-of-the-art MRI machine stands at the ready in the BCVI gallery in order to provide exquisite details of the cardiovascular system. RASF collaborates with all the equipment vendors to make sure that the tools we work with are not only first-class, but world-class.
The diagnostic equipment is only part of the equation. Endovascular and percutaneous treatment requires high-end tools and catheters, often available only here at BCVI and at elite sites around the world. As the first provider of TIPS in the United States and as a groundbreaking institute for innovation, the interventionalists of our group often use the most technologically advanced catheters, stents, and devices, often soon after first manufacture. Currently, the Institute is actively involved in more than 50 federally-approved clinical trials to find better ways of diagnosing and treating cardiovascular disease with new devices and drugs. Dr. Katzen and his team have treated some of the world's most famous people, and you can rest assured it is done with the best technology available.