Radiology

An x-ray is a painless and quick procedure that involves exposure to a small dose of radiation. A chest x-ray and x-rays of the bones are often taken to check your general health (e.g. before an anaesthetic) or to see if there has been any spread of cancer to other parts of the body.

Ultrasound scans use sound waves to build up a picture of the inside of the body. The sound waves are directed by a probe which also detects reflections of sound waves. A computer then converts them into a visible picture.

Ultrasound is a useful screening test as it doesn’t expose people to radiation. It also gives real-time pictures which can be used to direct procedures such as biopsy of the prostate. Ultrasound may provide inadequate detail in some circumstances and therefore further instigations may be necessary.

In this test, a small amount of radioactive material is injected into a vein in the arm. Abnormal bone absorbs more of the radioactive substance than normal bone and shows up on the scan as highlighted areas (known as 'hot spots'). The level of radioactivity that is used is very small, it requires a gamma camera to detect it. A bone scan is used mainly to detect the spread of cancer to the bones but can also detect other conditions affecting the bones such as arthritis, so further tests such as an X-ray of the abnormal area may be necessary to confirm the findings.

This scan is used to assess kidney function and whether the outflow of the kidney is blocked. After injection into the venous system, the compound is excreted by the kidney and its progress through the renal system can be tracked with a gamma camera.

DTPA renogram is often used for PUJ obstruction diagnosis (and follow-up after pyeloplasty) or before nephrectomy.

CT scan is basically an x-ray tube that rotates in a circle around the patient and takes a series of pictures as it rotates. The multiple x-ray pictures are reconstructed by a computer to provide detailed internal imaging.

The scan takes from 10-30 minutes. You may be given a drink or injection of a dye, which allows particular areas to be seen more clearly. For a few minutes, this may give you a hot sensation. The procedure is painless and you will probably be able to go home as soon as the scan is over.

CT scan has a wide range of uses and is one of the most regularly recommended scans for urological conditions.

The Prostate Specific Membrane Antigen (PSMA) is a protein found on the surface of most prostate cancer cells. It is the target of this scan in which a small amount of a radioactive marker is given that travels around the body seeking out and attaching to cells with this protein. A Positron Emission Tomography (PET) scan detects the marker and highlights where the cells are. A Computed Tomography (CT) scan then provides the detail of the anatomy. The two scans are fused together to give an overall picture of the location of the disease spread.

PSMA PET CT scans are generally not necessary for low to intermediate-risk diseases but can be very helpful for high-risk diseases to look for spread before treatment. Alternatively they may be used in the setting where the PSA test is increasing after treatment has already been given suggesting that there might be disease recurrence.

Magnetic Resonance Imaging (MRI) is another commonly used imaging technique. This test is similar to a CT scan but uses magnetism instead of X-rays to generate internal images. The subject's body is exposed to radio waves while in a magnetic field. Contrast agents or dyes may be used to help outline certain structures.

The level of detail provided by MRI may be superior to other types of scans in certain circumstances and an individual is not exposed to harmful radiation during this test. The scanner however is quite noisy and fairly confined so those with claustrophobia may find it uncomfortable.