Preparing for Your Visit

All MRI Scans

What to expect during your MRI at Lenox Hill Hospital

Lenox Hill Hospital offers our patients and customers alike, cutting-edge clinical, and fast head-to-toe whole body imaging, while proving increased patient comfort with our new Philips Intera Achieva 3.0T MRI system. This system provides a never before seen level of detail. Because of this level of technology, it is also one of the most patient-friendly exams by offering a faster scan time, reducing the need for contrast agents, thereby putting patients at ease.

Due to the increased scanning speed of our 3.0T system, most MRI scans last only 15 to 40 minutes. This scanner is also designed with the widest openings of any 3.0T system available – also providing another very important level of patient comfort.

This scanner provides optimal imaging results in many areas, such as:

• Musculoskeletal imaging ( i.e. spine, hips, shoulders, knees, wrists, ankles)
• Neurological imaging
• Vascular system imaging
• Spectroscopy of the brain and internal organs
• Cardiac MRI
• Whole body imaging

If you are claustrophobic, please contact our office for instructions. Music is available during the examination. You may bring your own tape or CD for the exam. Hair pins/clips must be removed prior to your examination. Please advise us if you are pregnant or have a cardiac pacemaker, cardiac valves, implanted cardiac defibrillator, aneurysm clips, cochlear ear implants, heart stents and/or retinal implants.

• MRI without Contrast: No preparation required.
• MRI with Contrast/MRA/MRV: If you have diabetes or kidney disease, have your recent (6 months or less)
  BUN and Creatinine levels available.
• MRI Abdomen: Do not eat or drink anything for 4 hours prior to examination.
• Breast MRI: Please schedule examination 8-13 days after the first day of your last menstrual cycle. Hormone Replacement Therapy (HRT) should be discontinued 3 months prior to the exam. Please bring all previous breast
  studies with you.

All CT Scans

What to expect during your CT Scan at Lenox Hill Hospital

Lenox Hill Hospital’s department of Radiology has the proud distinction of being one of only 2 hospitals on the entire east coast to provide this imaging technology. SPECT/CT is an imaging technique which combines the use of a CAT Scan (CT), and the use of a Single Photon Emission Computed Tomography (SPECT).

The CT portion uses a computer to combine multiple X-Rays images into a 2 dimensional cross-sectional image of the inside of the body.

The SPECT aspect measures the concentration of chemicals injected into the body, and provides images of the chemical function of the parts of the body of interest.

By fusing SPECT and CT scans into a single procedure, it enables us to obtain superior metabolic information provided by SPECT studies with the clear anatomical information gained from CT scans. Both of these studies are performed simultaneously on the same machine. The use of SPECT/CT, has proven to be valuable in assessing issues which traditionally could have only been addressed by performing invasive procedures.

If you have diabetes please have your recent (6 months or less) BUN and Creatinine levels available. Please notify our office for special instructions at least 3 days in advance if you are currently taking Metformin (ex: Glulcophage, Glucovance, Avandammet, Metaglip). If you require iodinated contrast for the CT scan, Metformin should not be taken for 48 hours following the contrast injection. Your doctor must recheck your blood levels of BUN and Creatinine before you restart your medication. Please notify our office for special instructions at least 3 days in advance if you are allergic to iodinated contrast (“iodine dye”) or have a history of multiple allergic reactions.

• Coronary CTA: No coffee, tea, Viagra, Levitra, or Cialis for 12 hours before study. No food 3 hours before study. Please drink 2-3 glasses of water prior to arrival.
• Cardiac Calcium Scoring: No caffeine on day of exam.
• CT with Injected/IV Contrast: No food 4 hours before study. Please drink 2-3 glasses of water prior to arrival.
• CT without Injected/IV Contrast: No preparation required.

Coronary CTA

Lenox Hill Hospital’s Department of Radiology uses the most advanced CTA scanner, the 64-slice Philips Brilliance Scanner. This scanner provides extremely high quality images of the coronary arteries with accuracy comparable to that of conventional invasive angiography.

The Coronary CTA study is a non-invasive heart-imaging test to determine whether the coronary arteries are narrowed by fatty deposits and/or calcium deposits. These substances, also known as plaques, reduce the flow of blood to the heart muscle and increase the risk of a heart attack. In addition, it yields important information concerning the kind of plaque (soft vs. hard) that cannot be obtained by any other non-invasive technology. Coronary CTA is sometimes performed instead of an angiogram and is the only test available that provides detailed three-dimensional (3-D) images of the artery walls.

This test also routinely provides a coronary calcium score, the best predictor of heart attack risk even in the absence of significant narrowing of the arteries.

Appropriate candidates for a Coronary CTA study would be:

• Patients who are at intermediate to high-risk for coronary artery disease based on risk factors (e.g., high cholesterol, high blood pressure, diabetes, smoking, family history).
• Those who have chest pain or shortness of breath, related or unrelated to exercise.
• Patients who have existing coronary bypass grafts or stents, and need confirmation that they are open.
• Patients who have unclear or inconclusive stress-test results or prior misleading stress tests.
• Those patients who require an alternative to stress-testing.

Ultrasound Studies

What to expect during your Ultrasound at Lenox Hill Hospital

• Sonohysterogram: Please call our office on the first day of your next period to schedule an appointment five to ten days later. No sexual intercourse during this time until after the procedure.
• Pelvis: Requires full bladder. Please drink 4 to 6 glasses of water starting 1 to 1-1/2 hours prior to test. Do not urinate after drinking the water.
• Obstetrics: Follow Pelvic Preparation.
• All Other Ultrasound Exams: No Preparations.

All Biopsies and Aspirations

For 1 week prior to the procedure, do not take any medications which may promote bleeding: aspirin, nonsteroidal anti-inflammatory drugs such as Advil, Motrin, ibuprofen, Anaprox, Aleve, naprosyn, etc., vitamin E supplements, or green tea. You may take Tylenol. If you are currently taking anticoagulants (coumadin or heparin), please contact the office and your referring physician for special instructions. Notify the office if you have previously taken prophylactic antibiotics for mitral valve prolapse. Contact the office if there is any chance you could be pregnant.

• CT Guided Biopsy: Nothing to eat or drink 4 hours prior to test. You may take a small amount of water with your medications. You will need someone to take you home after your procedure. Prior to the biopsy, CT films must be
  forwarded to the CT Department for the radiologist to review prior to the biopsy.
• Sono Guided Biopsy or Aspiration: Please eat prior to arrival. Prior ultrasound reports must be forwarded to the Ultrasound Department for the radiologist to review prior to the biopsy. Please fax to (212) 434-4567.

Nuclear Medicine

Learn about Nuclear Medicine at Lenox Hill Hospital

• Nuclear Thyroid Uptake and Scan: Do not eat kelp, seaweed, vitamins with minerals, or seafood for at least 3 days prior to the test.
• Hepatobiliary (HIDA) Scan: No solids or liquids by mouth for 4 hours prior to the test.
• PET Scan: Nothing to eat or drink, except water for 6 hours prior to the procedure. No nicotine, caffeine, alcohol for 12 hours prior to the exam. If you are diabetic, please notify our office for special instructions. Please bring any outside studies at the time of the exam.

PET/CT

A PET/CT exam takes both a PET (Positron Emission Tomography) scan and a CT (Computerized Tomography) scan, and merges the two types of imaging data into a combined PET/CT study.

The PET scan detects abnormal areas of cellular activity throughout the body. Since these changes often take place before any physical symptoms appear, a PET scan provides valuable data which enable your physician to make a much more timely diagnosis.

The CT scan combines the use of computers and X-ray technology, and provides a non-invasive two-or three-dimensional view of your internal anatomy for concise clinical evaluation.

When a PET exam and CT exam are done simultaneously, your physician is able to assess abnormalities in their exact anatomical location in your body. In addition, our 16 slice technology is a high performance system that offers exceptional quality while providing a patient friendly open design.

PET/CT exams also provide an opportunity for your physician to make a more timely decision regarding any future medical treatment needed, should disease be detected. It may also help determine the outcome of any planned future treatments.

Breast Imaging

Lenox Hill Hospital Radiology Department is pleased to announce our new Breast MRI imaging program, utilizing our state of the art super high strength 3 Tesla Magnet; and new Computer Assisted Detection (CAD) software to compliment our Breast MRI Guided Biopsies. These techniques have become increasingly important in the detection and delineation of breast cancer.

The American Cancer Society issued new Screening Breast MRI guidelines in March 2007, which recommends screening for women with approximately 20 – 25% or greater lifetime risk of breast cancer. This includes, among other women, those who have a proven genetic predisposition, women with a strong family history of breast or ovarian cancer and women treated for Hodgkin’s disease with chest irradiation.

Breast MRI has become increasingly important in the detection and delineation of breast cancer, as its main strengths include its exquisite resolution of soft tissue and its ability to image the breast in fine sections and in multiple planes, thereby providing four-dimensional information which is used to characterize lesions as benign or malignant.

A digital mammogram is different from the traditional mammogram because it replaces the use of x-ray film, with solid-state detectors that convert x-rays into electric signals – similar to those found in digital cameras. These electrical signals then produce images of the breast which can be viewed on either a computer screen, or printed on film. From the patient’s point of view, the entire procedure is the same as that of a traditional mammogram. However, the clarity of the images are superior to that of film mammography, thereby providing a more accurate study overall.

• Digital Mammography: No talcum, underarm deodorant or body lotion on day of test. Please bring all previous mammograms and breast sonograms on the day of exam.
• Sono Guided Biopsy, Stereotactic Biopsy or Aspiration: For 1 week prior to the procedure, do not take any medications which may promote bleeding: aspirin, nonsteroidal anti-inflammatory drugs such as Advil, Motrin, ibuprofen, Anaprox, Aleve, naprosyn, etc., vitamin E supplements, or green tea. You may take Tylenol. If you are currently taking anticoagulants (coumadin or heparin), please contact the office and your referring physician for special instructions. Notify the office if you have previously taken prophylactic antibiotics for mitral valve prolapse. Contact the office if there is any chance you could be pregnant.

Please eat prior to arrival. Prior ultrasound reports must be forwarded to the Ultrasound Department for the radiologist to review prior to the biopsy. Please fax to (212) 434-4567.

• Needle localization: You will be contacted with detailed instructions. Please bring all previous mammograms and breast sonograms.

Fluoroscopy

• GI Series and/or Small Bowel: Nothing to eat or drink after midnight prior to test.
• Barium Enema: Purchase a Fleet Prep Kit #3 from a pharmacy. Follow instructions for 24 hour prep. Nothing to eat or drink after midnight prior to test.
• Hysterosalpingogram: Please call our office on the first day of your next period to schedule an appointment five to ten days later. No sexual intercourse during this time until after the procedure. No food for 4 hours prior to the test.

Notify the office of any prior reaction to iodinated contrast (“iodine dye”).

IVP

Nothing to eat or drink 4 hours prior to exam.

• Premedication Regimen for Iodinated Contrast (“Iodine Dye”): Please notify the office of you have had prior contrast reactions. If intravenous contrast is still deemed necessary you will require a prescription from your physician for the following:
  • Prednisone: 50mg by mouth 13 hours prior to scan; 50mg by mouth 7 hours prior to scan; 50mg by mouth 1 hour prior to scan;
  • Benadryl: 50mg by mouth 1 hour prior to scan.

NOTE: You will not be able to drive or return to work for 12 hours.

Bone Densitometry (DEXA)

A bone densitometry scan is a special type of X-Ray used to measure the calcium content of the bones, usually in the lower back (the lumbar region), and the hips. Decreased amounts of calcium, will reveal a condition known as osteoporosis. Should this condition be present, the bone density scan will asses the risk of the possibility of a bone fracture within the next few years. A bone density study will typically take 10 to 30 minutes.