IMAGING TESTS This infrmatin may help answer sme f yur questins and help yu think f ther questins that yu may want t ask yur cancer care team; it is nt intended t replace advice r discussin between yu and yur cancer care team. Imaging tests allw the cancer care team t check fr cancer and ther prblems inside the bdy. Imaging tests invlve sending different types f energy, such as X-rays, sund waves, magnetic fields r radiactive particles, thrugh the bdy. Energy patterns are changed by the different tissues and structures in the bdy and these are displayed as an image n a screen. They allw the cancer care team t see changes that may be caused by cancer. There are fur main types f imaging used t diagnse and assess head and neck cancers: Ultrasund (US) scans: A prbe is placed n the skin surface that uses sund waves t lk in detail at sft tissues f the bdy. Ultrasund usually lks at smaller regins like the thyrid gland. It is nt used fr lking at bne r tissue with air in r arund it, like the lungs. Ultrasund des nt use radiatin and is safe during pregnancy and fr children. Cmputed tmgraphy (CT) scans: X-ray beams are used t create a detailed view f the bdy. CT can lk at large areas f the bdy very quickly and is very gd fr examining bne. Intravenus dye is ften used t help shw bld vessels and cancers during a CT scan. CT scans use radiatin and shuld be avided during pregnancy and in children where pssible. 1
Magnetic resnance imaging (MRI) scans: A very strng magnetic is used t create a detailed view f the bdy. MRI scans can lk at large areas f the bdy but they are quite slw and nisy. Many peple als find them claustrphbic. MRI is very gd fr lking at many different types f tissue but it is imprtant t lie very still during the scan. Intravenus dye is ften used t help shw bld vessels and cancers during an MRI scan. MRI can be dangerus in peple with metal in their bdy because the magnet can make the metal mve let the radigrapher knw if yu d but nt all types f metal are affected. MRI des nt use radiatin and is safe during pregnancy and fr children. Psitrn emissin tmgraphy (PET) scans: A special glucse slutin cntaining sme radiactive material (knwn as a raditracer) is injected int the bdy. The raditracer accumulates in the cells that use mre energy, including cancer cells, making these shw up as ht spts n the images. PET scans are very gd at detecting cancers that grw quickly but nt nes that grw slwly. PET scans can als give false readings due t inflammatin r muscle mvement (even talking r chewing). PET uses radiatin and shuld be avided during pregnancy and in children where pssible. WHY ARE IMAGING TESTS NEEDED? Imaging tests can be used t: lk fr cancer see ut hw far yur cancer has spread (knwn as staging) help determine which treatment, r cmbinatin f treatments, might be right fr yu help track whether cancer treatment is wrking. 2
HOW TO PREPARE FOR IMAGING TESTS Imaging tests are usually painless and d nt require special preparatin. If yu are having intravenus dye r a bipsy, a needle will be required. BEFORE AN ULTRASOUND OR CT, GUIDED BIOPSY LET THE RADIOLOGIST KNOW IF YOU: Take bld thinning medicatin fr a heart cnditin r bld clts (such as warfarin, Plavix, aspirin r Pradaxa), make sure the cancer care team is aware. Sme f these medicatins may need t be stpped mre than a week befre imaging. Have a bleeding prblem. BEFORE A CT SCAN LET THE RADIOGRAPHER KNOW IF YOU: Have had prblems with any cntrast used in imaging tests in the past. Als let them knw if yu have previusly had any reactins t seafd r idine, r any ther allergies. This is imprtant because previus reactins may increase yur risk f reacting t the cntrast material used in imaging scans. Have any kidney prblems; yu may als need t have bld tests t check yur kidney functin. This is because the cntrast material may affect yur kidneys. Are pregnant, think yu are pregnant, r are breastfeeding. BEFORE A PET SCAN LET THE NUCLEAR MEDICINE SPECIALIST KNOW IF YOU: Have diabetes; yu may need t fllw a different prcedure fr a PET scan. This is because the raditracer cntains glucse. Are pregnant, think yu are pregnant, r are breastfeeding. 3
BEFORE A MRI SCAN THE RADIOLOGIST KNOW IF YOU: Are wrried abut being in small, enclsed space (i.e. yu are claustrphbic). This is because an MRI scan invlves being in a cnfined space (a lng tube). The radilgist can help alleviate any cncerns by discussing the prcess in mre detail, shwing yu the MRI machine and/r giving yu medicine that helps yu relax befre the test. Have any irn-based metallic bjects in yur bdy as they may be damaged by an MRI scan. These include implanted defibrillatrs r pacemakers and metal cils put inside bld vessels (knwn as stents). Have any kidney prblems; yu may als need t have bld tests t check yur kidney functin. This is because the cntrast material may affect yur kidneys. WHAT TO EXPECT DURING THE SCAN Ultrasund is a nn-invasive and painless test perfrmed using a prbe n the skin surface that is cntrlled by an ultrasngrapher: It can be very helpful at defining sft tissues within the bdy and guiding bipsies. Depending n the numbers f areas t be lked at will, an US generally takes between 10 and 30 minutes. A CT scan may start with injecting an idine cntrast int a vein in the arm t help make the images clearer: This may make yu feel ht r flushed fr a few minutes. Yu will then lie still n a table that mves slwly thrugh the CT scanner, a dughnut-shaped machine. The scanning nly a few minutes, but the preparatin takes between 10 and 30 minutes. A MRI scan als starts with injecting a dye int a vein in the arm t help make the images clearer: The images are then taken while yu lie n a table that slides int a narrw metal cylinder that is pen at bth ends. The scanning takes abut an hur. 4
A PET scan als starts with injecting a raditracer: The raditracer is left t spread thrughut the bdy and accumulate in the cells that use mre energy (including cancer cells) fr between 30 and 90 minutes. Yu will need t lie still during this time. Cells that have accumulated mre raditracer shw up as ht spts during the scan, which takes arund 30 minutes. WHAT TO EXPECT AFTER THE IMAGING SCAN After the scans are cmplete, yu may be asked t wait while the images are checked t make sure they clearly shw the parts f the bdy that are f interest. If nt, mre scans may be needed. Drink several glasses f water after a PET scan t help flush the raditracer ut f the bdy. POSSIBLE SIDE EFFECTS OF IMAGING TESTS US require n radiatin and is safe, given that it nly uses sund waves at the skin surface. Althugh CT and PET scans invlve expsure t radiatin, the radiatin levels are t lw t affect the nrmal prcesses f the bdy. Hwever, expsure t radiatin shuld be avided if yu are pregnant r breastfeeding. Other pssible side effects include anxiety if yu are claustrphbic r uncmfrtable with needles. It is als pssible t have an allergic reactin t the cntrast medium r raditracer. 5
QUESTIONS TO ASK YOUR DOCTOR Why d I need imaging tests? Will imaging tests cnfirm the diagnsis f cancer? What exactly will be dne during the imaging tests? Wh will carry ut the imaging tests? Hw much will the scans cst? Will my health insurance cver it? Are there any pssible side effects I need t knw abut and wh d I cntact if they happen? Can I drive/g t wrk after the scans? Des the scan invlve radiatin? Is there an alternative test that culd be dne? Beynd Five disclaimer: Yu acknwledge and accept that the infrmatin in this factsheet is fr general infrmatin purpses nly. It is nt intended, nr shuld it be relied n, as medical r legal advice, r as a substitute fr cnsultatin with a physician r ther licensed healthcare prvider. Yu agree that if yu have individual healthcare-related questins yu shuld cntact yur dctr prmptly and shuld nt disregard prfessinal medical advice, r delay seeking it, because f infrmatin cntained here. Yu als agree that Beynd Five is nt liable fr any injury r damage t persns r prperty (hwsever caused, including by negligence) arising ut f r related t any use f Beynd Five s patient educatin materials, r fr any errrs r missins. Last updated: 17 Octber 2016 6