PARTNER MEDIZINISCHE BILDGEBUNG

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1 RADIOLOGICAL PRACTICE 9

PARTNER MEDIZINISCHE BILDGEBUNG Radiological Practice Calw Leonberg OUR PHILOSOPHY To us patient care and modern radiological imaging go hand in hand.

2 PARTNER MEDIZINISCHE BILDGEBUNG Radiological Practice Calw Leonberg OUR PHILOSOPHY To us patient care and modern radiological imaging go hand in hand. The patient entrusted to us stands at the center of all efforts and all actions evolve around the well-being of the patient. During the past years great technical and methodic developments have taken place within the field of diagnostic radiology. New imaging techniques have emerged and patient safety and comfort has substantially improved. These technological developments, methods and strategies are readily available within a pleasant environment at our practice. It is our goal to offer a combination of the highest diagnostic quality and optimized organizational procedures for the patients and for referring physicians. On the following pages we present the most important imaging modalities and introduce our practice locations in Calw and Leonberg. An English speaking physician and English speaking receptionists are on site. Sincerely, your team of radiologists Dr. med. Felbinger Dr. med. Dipl. Phys. Guhl Dr. med. Martensen Dr. med. Neumann Dr. med. Scholtz Range of Radiological services Magnetic Resonance Imaging (MRI) Computer Tomography (CT) Digital X-Ray Digital Mammography Mammography screening in the region of Calw Ultrasound of the breast CT-guided pain therapy Bone Densitometry 1 2

DIGITAL X-RAY In diagnostic radiology, strategies for avoiding and minimizing radiation exposure play a central role.

In diagnostic imaging of the skeletal system, the lung, the digestive tract and the urinary tract, the utilization of x-rays cannot always be avoided.

These systems enable a significant dose reduction in comparison with conventional systems at notably better image quality.

3 DIGITAL X-RAY In diagnostic radiology, strategies for avoiding and minimizing radiation exposure play a central role. Whenever possible, imaging modalities without the utilization of x-rays such as ultrasound and magnetic resonance imaging (MRI) are applied. In diagnostic imaging of the skeletal system, the lung, the digestive tract and the urinary tract, the utilization of x-rays cannot always be avoided. In our practice digital x-ray systems using storage phosphor plates and digital flat panel detectors of the newest generation are available. These systems enable a significant dose reduction in comparison with conventional systems at notably better image quality. The radiological practice PARTNER MEDIZI- NISCHE BILDGEBUNG located in Calw and in Leonberg operates fully digitalized. A digital system for picture archiving and communication (PACS) enable rapid access to images and reports for referring physicians. In most cases the patient will receive a CD with the images immediately after the examination. An important tool for avoiding double examinations is the x-ray booklet. We issue x-ray booklets free of charge after performing an x-ray examination. Please bring following items when scheduled for an x-ray examination: Letter of referral and insurance card Prior examinations and reports X-ray booklet (if existent) Prior x-ray images (if existent) Appointments by telephone Calw Leonberg

DIAGNOSTIC IMAGING OF THE BREAST Mammography is an established imaging modality of the female breast for the early detection of breast cancer.

Additionally, mammography plays an important role in the detection of inflammatory disease of the breast and is performed as a follow-up examination after breast cancer.

In these cases an additional ultrasound examination or a magnetic resonance examination (MRI) may be required.

4 DIAGNOSTIC IMAGING OF THE BREAST Mammography is an established imaging modality of the female breast for the early detection of breast cancer. Mammography is performed as a part of a national program for early detection of breast cancer, the so-called Mammography Screening Program. Additionally, mammography plays an important role in the detection of inflammatory disease of the breast and is performed as a follow-up examination after breast cancer. Due to the highly advanced treatment possibilities, the cure rate of early stage breast cancer lies above 80 %. When the breast tissue is densely configured the validity of mammography is limited. In these cases an additional ultrasound examination or a magnetic resonance examination (MRI) may be required. In our practice, digital mammography systems of the newest generation using storage phosphor plates and digital flat panel detectors are installed. These systems enable a significant reduction of radiation exposure in comparison with conventional systems at notably better image quality. Furthermore the duration of the examination is shortened. No specific preparations are necessary for mammography. Please bring following items when scheduled for the mammography examination: Letter of referral and insurance card Prior examinations and reports X-ray booklet (if existent) Prior x-ray images (if existent) Appointments by telephone Calw Leonberg

MAMMOGRAPHY SCREENING PROGRAM Breast cancer is the most common cause of death for women. Approximately 10% of all women in Germany develop breast cancer in the course of their lives.

5 MAMMOGRAPHY SCREENING PROGRAM Breast cancer is the most common cause of death for women. Approximately 10% of all women in Germany develop breast cancer in the course of their lives. That makes approximately women each year, of which succumb to the disease. The incidence of the disease is rising and the peak age lies above 50 years of age. If breast cancer is detected at an early stage, before it can even be felt, it is curable in approximately 90% of all cases. The mammography screening programs that have been carried out in neighboring European countries foremost the Scandinavian countries have resulted in a substantial reduction of mortality due to breast cancer. Due to these reasons, the German government has initialized a national program for the early detection of breast cancer, commonly known as the Mammography Screening Program. The program entails a series of mammographies performed at regular intervals. The Mammography Screening Program is the most sensitive method for early detection of breast cancer and yields the best results when performed according to the defined quality control standards. The program applies to all women between 50 and 69 years of age. The examinations are performed at an interval of 2 years. Participation is free of charge. THE PROGRAM All women eligible for participation receive a personal invitation for mammography screening every 2 years. The invitations are distributed automatically by the Kassenärztliche Vereinigung Baden-Württemberg, situated in Baden-Baden. The invitations are commonly delivered by mail and contain a suggested examination date. For this purpose the necessary data is retrieved from the local residents registration office. The program is conducted under strict measures of quality control and is performed according to the standardized European guidelines. The compliance with the defined standards is continually monitored by several instances and additionally by a dedicated center of reference. The strict guidelines ensure following quality features: All mammographies are subject to a multilevel Modern mammography systems quality control Mammography screening is performed only The images are read by two separate physicians at qualified institutions, specially certified and which have obtained special qualifications in equipped for this purpose mammography The x-ray examinations are performed exclusively Each physician must read at least examinations by trained technical assistants with additional each year qualification in mammography The result of the examination will be delivered in writing within two weeks. On demand, the patient s gynecologist or general practitioner can be notified directly. In case of a suspicious finding, the patient will receive an invitation for further diagnostic measures within few days. In this case, additional x-ray images and an ultrasound examination are usually performed. The radiological practice PARTNER MEDIZINISCHE BILDGEBUNG is responsible for the screening program in the county of Calw. The examinations are performed in a separate section of the practice at the following location: Eduard-Conz-Str. 11, Calw, 1. floor (Ärztehaus, directly above the parking garage). Detailed information about the Mammography Screening Program is available here:

BONE DENSITOMETRY (OSTEOPOROSIS) Bone densitometry is performed in order to diagnose and evaluate osteoporosis.

paralysis), malnutrition, metabolic disease and advanced age. Osteoporosis presents more commonly in women.

$Above all, this serves to evaluate the increased risk of fractures due to osteoporosis.$

6 BONE DENSITOMETRY (OSTEOPOROSIS) Bone densitometry is performed in order to diagnose and evaluate osteoporosis. Osteoporosis describes a reduction of bone mineralization and thereby a reduction of bone stability. Possible causes of osteoporosis are lack of exercise (e.g. paralysis), malnutrition, metabolic disease and advanced age. Osteoporosis presents more commonly in women. In order to initiate therapy of osteoporosis, the state of disease must first be quantified and expressed in numbers. Above all, this serves to evaluate the increased risk of fractures due to osteoporosis. Bone densitometry is performed by computer tomography (CT) of defined regions of the lumbar vertebrae (QCT) and of the femoral neck (CT-XA). The resulting images are evaluated using a computer program, which calculates the bone density of these regions in comparison to a standard population. For Bone Densitometry early registration is required: Please bring following items when scheduled for bone densitometry: Letter of referral and insurance card Prior examinations and reports (if existent) X-ray booklet (if existent) Prior x-ray images (if existent) Appointments by telephone Calw Leonberg

COMPUTER TOMOGRAPHY I Computer tomography is an imaging modality with which an x-ray beam is rotated around the patient yielding cross-section

A high performance computer enables the reconstruction of images in any given projection and the visualization of organs in 3-D tech - nique.

Classic areas of application are diseases of the brain, lungs, internal organs and vertebral discs.

The scanners are equipped with a special low dose technology (ASiR = Adaptive Statistical iterative Reconstruction), allowing a dose reduction

The high rotation speed of the x-ray emitter and the simultaneous motion of the table through the opening of the scanner (spiral technique)

Especially in the field of emergency medicine, this saves valuable time.

7 COMPUTER TOMOGRAPHY I Computer tomography is an imaging modality with which an x-ray beam is rotated around the patient yielding cross-section images (tomograms) of the examined region. A high performance computer enables the reconstruction of images in any given projection and the visualization of organs in 3-D tech - nique. Thus, the radiologist possesses a powerful and rapid tool for precise diagnoses. Classic areas of application are diseases of the brain, lungs, internal organs and vertebral discs. At our practice we operate so-called volume scanners of the newest generation. The scanners are equipped with a special low dose technology (ASiR = Adaptive Statistical iterative Reconstruction), allowing a dose reduction of up to 80 % for cardiac imaging and up to 40 % compared to conventional systems. The high rotation speed of the x-ray emitter and the simultaneous motion of the table through the opening of the scanner (spiral technique) allow a full examination of the entire body in only a few seconds and with a resolution of 0,6 mm slice thickness. Especially in the field of emergency medicine, this saves valuable time. Please confer with your physician or with or with our practice regarding the necessary preparations for a CT scan. In most cases you must not eat or drink 4 hours prior to the examination. This serves to reduce the risk of complications when contrast agent is administered. Please bring following items when scheduled for a CT scan: Letter of referral and insurance card Prior examinations and reports (if existent) X-ray booklet (if existent) Prior x-ray images (if existent) Creatinine- and TSH- laboratory results in case an intravenous contrast administration is necessary

COMPUTER TOMOGRAPHY II The radiological practice Calw-Leonberg operates CT scanners

Thus, making a powerful imaging modality available to our patients without the risk

Classic areas of application are diseases of the brain, lungs, internal organs and

The modern CT scanners enable a virtual view of the internal structure of the body.

valves, the digestive tract and of the arterial system can be realized and are

In many cases invasive procedures such as Endoscopy and Cardiac catheterization can

A further application of computer tomography is CT guided pain therapy.

8 COMPUTER TOMOGRAPHY II The radiological practice Calw-Leonberg operates CT scanners of the latest generation, so called volume scanners. Thus, making a powerful imaging modality available to our patients without the risk of excessive radiation exposure. Classic areas of application are diseases of the brain, lungs, internal organs and the vertebral column. The modern CT scanners enable a virtual view of the internal structure of the body. In many cases an intravenous administration of contrast agent is required for the examination. 3-D visualization of the bronchial system, the coronary arteries, the cardiac valves, the digestive tract and of the arterial system can be realized and are performed routinely. In many cases invasive procedures such as Endoscopy and Cardiac catheterization can thus be avoided. A further application of computer tomography is CT guided pain therapy. With the help of a three-dimensional laser system a thin injection needle is inserted under local anesthesia. The exact location of the needle is verified by low dose CT images. Using this method, anti-inflammatory drugs and local anesthetics can be injected with high precision in the area of the intervertebral joints, the sacroiliac joints or in the area of the nerve root. Appointments by telephone Calw Leonberg

MAGNETIC RESONANCE IMAGING Specially dedicated imaging protocols allow the exact visualization of, for example, the beating heart, the digestive tract, the bile duct, spinal fluid,

Many general practitioners and medical specialists routinely utilize MRI as a diagnostic Magnetic resonance imaging (MRI) is an imaging modality capable of generating detailed

Sectional images (tomograms) are then calculated from the resulting data by a powerful computer.

By varying the radio waves and adding additional overlapping magnetic fields, certain characteristics of tissues within the body can be either accentuated or suppressed.

tool early in the diagnostic process. Thus, the use of MRI shortens the overall course of treatment and can enable a more targeted approach.

In most cases patients with pacemakers cannot be examined with MRI.

9 MAGNETIC RESONANCE IMAGING Specially dedicated imaging protocols allow the exact visualization of, for example, the beating heart, the digestive tract, the bile duct, spinal fluid, or the arteries with or without the administration of a contrast agent. During the past decade the role of MRI has changed. Many general practitioners and medical specialists routinely utilize MRI as a diagnostic Magnetic resonance imaging (MRI) is an imaging modality capable of generating detailed images of structures within the body without exposing the patient to radiation. The image date is created using a strong magnetic field and radio waves. Sectional images (tomograms) are then calculated from the resulting data by a powerful computer. Adverse side effects of this imaging modality have not been proven in 30 years of use. In most cases, pacemaker patients cannot be examined with magnetic resonance imaging. By varying the radio waves and adding additional overlapping magnetic fields, certain characteristics of tissues within the body can be either accentuated or suppressed. These attributes make magnetic resonance imaging an ideal imaging modality for organs such as the brain, spine, internal organs, joints and vessels. tool early in the diagnostic process. Thus, the use of MRI shortens the overall course of treatment and can enable a more targeted approach. The newest generation of MRI scanners with a wide bore of 70 cm, a short magnet and short examination times appeal to patients with claustrophobia and obese patients. In most cases patients with pacemakers cannot be examined with MRI. Most patients with implants such as joint prosthesis, inner ear implants, cardiac valve prosthesis or foreign metal bodies are eligible for MRI examinations but each case must be reviewed individually. Please inform us about any implants of foreign bodies when registering for your appointment. Please bring following items when scheduled for an MRI examination: Letter of referral and insurance card Prior examinations and reports (if existent) Implant information booklet (if existent) Appointments by telephone Calw Leonberg

OUR LOCATIONS In 1995, Dr. med. Dipl. Phys. Guhl founded the radiological practice in Calw and simultaneously took over the leading position of the radiological department in the hospital of Calw.

Furthermore the practice supplies diagnostic imaging services to the hospital in Calw and to patients referred from practitioners in and beyond the county of Calw.

10 OUR LOCATIONS In 1995, Dr. med. Dipl. Phys. Guhl founded the radiological practice in Calw and simultaneously took over the leading position of the radiological department in the hospital of Calw. Today the radiological practice, PARTNER MEDIZINISCHE BILDGEBUNG, consists of 5 radiologists. Furthermore the practice supplies diagnostic imaging services to the hospital in Calw and to patients referred from practitioners in and beyond the county of Calw. The clinics for orthopedic surgery, general surgery, internal medicine, cardiology, neurology, anesthetics and intensive care, gynecology and obstetrics, ENT and ophthalmology and the affiliated clinics in Nagold provide medical care for the county of Calw. The radiological practice, PARTNER MEDIZINISCH BILDGEBUNG, cooperates closely with the referring physicians in the region and guarantees the highest standard of radiological services. In the year 2012 the practice PARTNER MEDIZINISCHE BILD- GEBUNG opened a subsidiary branch located in the Römergalerie in Leonberg. The centrally located practice was planned and equipped according to the most modern standards, allowing optimized patient care in pleasant surroundings. The radiological services provided by the practice are available to all referring physicians in the Region

11 PARTNER MEDIZINISCHE BILDGEBUNG Radiologische Gemeinschaftspraxis Calw Leonberg Dr. med. Felbinger, Dr. med. Dipl. Phys. Guhl, Dr. med. Martensen, Dr. med. Neumann, Dr. med. Scholtz Location in Calw Kreiskliniken Calw, 3. floor Eduard-Conz-Straße Calw Location in Leonberg Römergalerie, 1. OG (opposite Leo-center) Eltinger Straße Leonberg Appointments: Tel Fax Appointments: Tel Fax Opening hours: Mon. Tue. Wed. 8:00 16:00 Thu. 8:00 12:00 Fri. 8:30 16:00 Opening hours: Mon. Thu. 8:00 16:00 Fri. 8:30 16:00 Appointments outside regular opening hours are possible upon request. Parking is available in the parking garage directly across the main hospital building. Appointments outside regular opening hours are possible upon request. Parking is available in the parking garage within the building. Please make timely arrangements for an appointment. Naturally, urgent appoints can be arranged on short notice. Please inform us if you are not able to keep your appointment.

ANNOUNCING THE NEW STONY BROOK UNIVERSITY OUTPATIENT IMAGING CENTER

ANNOUNCING THE NEW STONY BROOK UNIVERSITY OUTPATIENT IMAGING CENTER PROVIDING THE MOST ADVANCED DIAGNOSTICS FOR THE HIGHEST QUALITY OF CARE Call Our Dedicated Line: (631) 638-2121 When you need the benefit