Frequently Asked Questions

A 3D Screening Mammography is “the big picture” while Diagnostic Mammography is “the detail”. A screening mammogram is a routine low-dose x-ray of the breasts performed to detect small abnormalities before they can be felt on an exam. A diagnostic mammogram is performed to evaluate a breast concern such as breast lump, discharge, pain, or to further characterize an abnormal area seen on a screening mammogram.

The mammography technologist will walk you through the process of what is needed to obtain the best images. The technologist will position each breast onto a rectangular curved paddle of the mammogram machine and apply gentle pressure to obtain the x-ray images. You will hold your breath for a few seconds for each view to avoid motion on the images. The technologist will provide instructions on how and when you will obtain your results. 

Screening Mammograms are able to detect findings as small as grains of sand or subtle masses before they can be felt on palpation. The patterns of the mammogram abnormalities determine the degree of suspicion. Most abnormal findings on a screening mammogram prove to be benign (noncancerous) on additional mammogram views or ultrasound. Findings that are persistently suspicious on the additional evaluation are biopsied. 

To evaluate a breast concern such as breast lump, discharge, pain, or to further characterize an abnormal area seen on a screening mammogram.

A diagnostic mammogram is performed using low dose x-ray to evaluate a breast concern such as breast lump, discharge, pain, or to further characterize an abnormal area seen on a screening mammogram. The same mammogram machine is used for performing screening and diagnostic exams. The difference is the use of specialized compression paddles, magnification or different angles used for diagnostic exams to bring out characteristics of benign versus malignant tumors.

A Breast Ultrasound may be performed after a Screening Mammogram to get a ‘closer look’ at a particular area. A breast ultrasound may also be performed to evaluate a specific breast complaint such as a lump or focal pain. The Radiologist will interpret the results to determine if the finding is a benign process such as a cyst of a suspicious lesion that requires biopsy. 

It depends on the situation. If the Radiologist finds a nodule or mass on the initial Screening Mammogram,  then a Breast Ultrasound will be recommended to obtain a better view of the mass to help finalize the results. If there is a clearly benign finding such as a simple cysts, no follow will be required. If a potentially suspicious finding is discovered, a needle biopsy will be recommended. 

Ultrasound is a radiology imaging technology that uses sound waves to characterize masses versus cysts in the breast. Sound waves are emitted from crystals in a hand-held wand called a transducer or probe. The sound waves reflected back are presented as images for interpretation by a specialized radiologist to distinguish various findings. Many of the findings we see on a breast ultrasound are too small or too deep to be felt on examination. Some clinicians will recommend whole breast ultrasound to detect small  lesions in the breast before they can be felt. This may be in addition or as a substitute for mammography. 

A doctor may order a thyroid ultrasound to evaluate any physical changes of the thyroid gland such as an enlargement or difficulty swallowing.  

A thyroid ultrasound will show any masses or subtle changes in the thyroid gland that could be associated with benign (non-cancerous) versus malignant (cancerous) nodules. Most nodules of the thyroid are benign. 

Depending on the size, shape, and characteristics of the nodule, a biopsy might be indicated called a Fine Needle Aspiration. Most nodules will require a follow-up ultrasound within a short interval versus  a biopsy. 

Under ultrasound guidance, a very small needle is introduced into the thyroid gland after numbing the area. It feels like a light pressure for a few minutes while obtaining the cells. The sample is then interpreted by the pathologist. 

The blood test will interpret the function of the thyroid gland while the Ultrasound evaluates the anatomy. 

A Pelvic Ultrasound may be ordered by your physician to get a detailed look at the pelvic organs including the uterus, cervix, ovaries, and fallopian tubes. The bladder is also considered part of the pelvic space. Because ultrasound excels at evaluating organs that are fluid-filled, it excels at evaluating solid or fluid-filled organs but is not optimal for evaluating gas-filled organs such as the bowel. 

Pelvic ultrasound imaging has two components. The first part of the study is to look at the pelvic organs from the outside of your abdomen called a Transabdominal Pelvic Ultrasound. A curved transducer that emits ultrasound waves is gently positioned on your lower abdomen over the pelvic organs. The filled bladder acts as a lens to focus better on the pelvic organs. The second part of the exam uses another kind of transducer that resembles a tampon called a Transvaginal Ultrasound probe (wand). The probe is inserted into the vaginal canal like a tampon is inserted. You may insert the probe instead of the technologist if you desire. Using Transvaginal Pelvic Ultrasound we can obtain more detailed images of  the ovaries and uterine lining. The cervix is also evaluated but we can only see the gross anatomy, not the pathology like a PAP smear does. 

The technologist or radiologist will be able to share the Pelvic Ultrasound results with you at the time of the study. Your clinician will receive those results within 24 hours, unless comparisons are required which may take longer. You will then follow up with your referring clinician regarding their care plan. The technologist and radiologist will not be able to prescribe any treatment - that is solely the responsibility of the referring clinician as they are the ones who determine any next steps. 

A Pelvic Ultrasound is optimal to evaluate any solid or fluid-filled organs such as for finding uterine fibroids, ovarian cysts or endometrial (pelvic lining) problems like hyperplasia or polyps. Sinec ultrasound excels at seeing fluid, it is also used to evaluate for excess fluids in patients who complain of “bloating”. 

A Pelvic Ultrasound cannot visualize gas-filled structures so lower abdominal pain that could be caused by small or large  bowel problems cannot be determined by this technique. Very small structures such as fallopian tubes are typically seen by Pelvic Ultrasound unless there is excess water in the tubes called hydrosalpinx. 

One breast imaging examination is not better than the other. There are different types of imaging examinations performed for different indications. Mammograms are still considered the first line in breast imaging, and the MRI is a supplemental imaging scan for “high risk imaging” or to evaluate the “extent of disease’ after an abnormal breast biopsy.

• Who should get a Breast MRI?

Some women with a strong family history of breast cancer or other personal risk factors may be recommended to perform breast MRI on a regular basis to look for subtle vascular differences in the breast tissue that may represent early cancer.

Mammography can still detect some types of breast cancer that MRI can not detect so some women may need both. MRI of the breast is not recommended by the American College of Radiology for women of average or low risk because of the chance of false alarms.

A Breast MRI is commonly performed to distinguish normal versus pathological tissues. In an asymptotic woman with a strong family history of breast cancer, a surveillance MRI may show subtle vascular changes in adjacent tissues that allows early cancer to stand out. In women with a recent abnormal breast biopsy for a precancerous or cancerous condition, MRI helps to eliminate other areas of concern or provide a map for the breast surgeon preoperatively. MRI of the breast can also be used as a diagnostic scan to find the reason for a persistent complaint as bloody nipple discharge that cannot be detected on diagnostic mammogram or ultrasound imaging. 

The Women's Imaging Center Radiologist or your referring clinician will determine if this exam is the best one for you. Most MRIs require insurance authorization which we will obtain from your carrier. This process can take up to 72 working hours, but some insurance plans may take longer than others to approve the examination.

Breast MRIs require intravenous contrast to show subtle differences in tissue types so an IV will be inserted in the arm or hand. If you have never had an IV placed, it's a very tiny flexible catheter through which we inject the contrast agent (called Gadolinium). You lay comfortably on your abdomen and the padded breast coils are fitted around the breasts, and your MRI technologist checks your position and preliminary imaging before the administration of contrast. Both breasts are scanned at the same time. 
The technologist then injects the contrast dye which is taken up differently in different types of tissues to different degrees. The coils are used to pick up the MRI signals. The signals are converted to images for the radiologists to interpret. There are often more than 1,000 images to review so the examination results are not immediately available. 

The amount of time that an MRI takes depends on whether contrast dye needs to be administered or whether special imaging sequences are needed. Almost all breast MRI requires the use of intravenous  contrast. However, if the MRI examination is ordered to evaluate breast implants alone (not the breast tissue), then contrast is not required. The usual time for MRI of the breasts for either indication takes approximately 35 minutes. 

For preventative or screening MRI examinations, you will be notified by mail regarding your results with instructions of whether any follow up is indicated. We will coordinate that follow up through our office.  Your referring clinician will also receive a copy of that report.

However, if the exam is performed for a diagnostic reason such as after an abnormal breast biopsy, your ordering clinician or surgeon receives that report. The clinician who will act on those results will discuss those results at your consultation.

A Pelvic MRI may be ordered by your physician to get a detailed look at the pelvic organs including the uterus, cervix, ovaries, and fallopian tubes. The bladder and rectum are also considered part of the pelvic space. MRI may help evaluate more closely complex ovarian cysts, endometriosis, or vascular uterine fibroids. 

Your clinician may want to specifically evaluate the lining of the uterus (the endometrium) after an abnormal pelvic ultrasound or endometrial biopsy. Pelvic MRI is also used to evaluate pelvic floor prolapse or urinary incontinence. Sometimes a pelvic MRI is ordered to make a diagnosis for a symptom such as heavy menstrual bleeding or persistent cramping. This high-tech medical diagnostic radiology imaging can give a GYN or surgeon a more detailed map prior to anticipated surgery. 

Before the MRI is performed, we may inject a contrast dye (called Gadolinium) into a vein in your arm. The contrast is taken up differently in different types of tissues to different degrees. You will be lying on your back on a comfortable table that moves into and out of the MRI machine. The magnet makes a loud clunky sound so the technologists will fit you with comfortable headphones and you may choose to listen to music through the headphone that makes the magnet sound indistinct. It is important not to move quickly or jerk during the exam because this may cause irregularities in the images from signals of the magnets moving. 

Hundreds of images from the pelvic MRI in various sequences will be produced for each study that needs to be interpreted. Therefore, the results will not be immediately available. An MRI specialist or the patient navigator will call you regarding your results once the interpretation is complete.

If you have any prior examinations elsewhere, please let us know the location so that we can obtain these for faster comparison.

A Spine MRI may be ordered by your physician to get a more detailed look at the spinal cord, vertebral bodies, discs, ligaments, and larger nerves. MRI may help determine the reason for spine pain, injury after trauma, or to diagnose tumors. MRI may be used to evaluate neurologic conditions such as Multiple Sclerosis. A Spine MRI of the neck (cervical spine), mid-back (thoracic spine), or lower back (lumbar spine) can give a surgeon a more detailed map prior to anticipated surgery. 

Magnetic Resonance Imaging (MRI for short) is an imaging technology that uses magnets and radio waves to produce detailed 3-D Imaging of the vertebrae, spinal cord, and associated anatomy. These signals are then converted to images for the radiologists to interpret. MRI is commonly performed to identify a reason for your symptoms. 

A Shoulder MRI (Magnetic Resonance Imaging) is an imaging technology that uses magnets and radio waves to produce detailed 3-D Imaging of the shoulder and joint. These signals are then converted to images for the radiologists to interpret.

• MRI is commonly performed to distinguish normal tissues from injured or pathologic tissues.

MRI is also used as a diagnostic scan to find the reason for a complaint or symptom. It is sometimes used to diagnose tumors.

You will be lying on your back on a comfortable table that moves into and out of the MRI machine. The magnet (within the MRI machine) makes a loud clunky sound. The technologists will fit you with comfortable headphones. You may choose to listen to music through headphones. It is important not to move quickly or jerk during the exam. Jerking may cause irregularities in the images from signals of the magnets moving.

An MRI of the shoulder is usually performed without the need for intravenous (IV) contrast dye. If your clinician is looking for a tumor, he or she may order a “contrast MRI”. This means that the technologist will inject a dye into the vein in your arm. Tumors tend to be vascular and the dye enhances (highlights or outlines) the tumor.

A Hip MRI is a radiology imaging examination used to diagnose a complaint or symptom. In Colorado’s active population, hip complaints are common from trauma, overuse, and arthritis. Your clinician may order an MRI to evaluate hip pain after sudden trauma like an accident or sports injury.

MRI is also used to evaluate long-standing complaints such as arthritis. The technology can evaluate fluid in the joint easily and even distinguish whether that fluid represents blood (called hemarthrosis) or inflammation (called bursitis). 

You will be asked to complete the medical history of any underlying medical conditions. Please tell the scheduler and the technologist if you have any metal in your body such as metal fragments from trauma or surgery that may be an issue for the “magnetic pull” of the MRI. 

Tell us if you have had any surgery or other procedures anywhere on your body including your limbs, abdomen, brain, or heart.

If you have any implanted devices such as pacemakers, defibrillators, aneurysm clips, auditory hearing implants, neurotransmitters, internal wires or electrodes, implanted pumps or ports, surgical mesh, any coils, stents, or filters please tell your technologist before scheduling because an MRI may not be possible.

• Many cardiac pacemakers and defibrillators are not compatible with MRI. Some of the newer devices are so it is important to know from your surgeon and the manufacturer what kind you have.

Some external body wear or designs such as body or face/ makeup tattooing, and permanent piercings may limit you from having the MRI. Current or prior metal workers may have small fragments in their eyes as an occupational hazard. You may be asked to have an x-ray prior to performing the MRI. Jewelry and piercings need to be taken out by you for your safety prior to the MRI exam.

A Knee MRI is often used to find the reason for a complaint or symptom such as pain. For Colorado's active population, knee complaints are common from trauma or other causes. To examine fractured bones caused by trauma, radiologists use regular X-rays. Yet, the components within the joints and between the bones need MRI to look further. Common subtle injuries to the knee are meniscus, tendons, and ligament tears which are all best evaluated by MRI. However, sometimes an MRI only shows swelling of these soft tissue structures and not a tear. Ask your doctor to see if an MRI is the right imaging exam for you. 

Ultrasound is a radiology imaging technology that uses sound waves to characterize lumps or masses in the breast. Sound waves are emitted from crystals in a hand-held wand called a transducer or probe. The sound waves reflected back are presented as images for interpretation by a specialized radiologist to distinguish various findings.

No. No treatment will completely stop menopause, but it can help alleviate some of the symptoms you experience. 

No. No treatment will completely stop menopause, but it can help alleviate some of the symptoms you experience. 

Ultrasound is a radiology imaging technology that uses sound waves to characterize lumps or masses in the breast. Sound waves are emitted from crystals in a hand-held wand called a transducer or probe. The sound waves reflected back are presented as images for interpretation by a specialized radiologist to distinguish various findings.

No. No treatment will completely stop menopause, but it can help alleviate some of the symptoms you experience. 

Ultrasound is a radiology imaging technology that uses sound waves to characterize lumps or masses in the breast. Sound waves are emitted from crystals in a hand-held wand called a transducer or probe. The sound waves reflected back are presented as images for interpretation by a specialized radiologist to distinguish various findings.

No. No treatment will completely stop menopause, but it can help alleviate some of the symptoms you experience. 

No. No treatment will completely stop menopause, but it can help alleviate some of the symptoms you experience. 

No. No treatment will completely stop menopause, but it can help alleviate some of the symptoms you experience.