Cost

• Inexpensive

• Generally non-invasive

• Essentially no mortality or morbidity

• Endovaginal, transesophageal, and endocavitary US carry procedural risks related to introduction of the US probe

• MCG US phone number: 1-4071

• Vascular US phone number: 1-5201

• Relatively easily available

• No obstetric US is performed in the imaging department except emergency examinations for potential ectopic pregnancy after normal business hours

• No in-house US capability after 10PM

• Patients should be NPO X 4 hours for GB, liver, pancreas, and biliary ductal examination

• US has no definite fixed weight limit, but image quality and penetration decline as weight and/or size increases

• Vascular US has no weight limit per se, but very large limbs will have poor quality results or not be able to be meaningfully examined

Cost

• Expensive

• Mortality and morbidity related to radiation exposure (especially children, breast tissue, and ovaries/testes)

• Risk related to IV contrast use (death approximately 1 case per 40,000 – 100,000 uses)

• MCG CT phone number: 1-1111

• CMC CT telephone number: 1-5210

• Relatively easily available

• Generally non-invasive

• All patients must be assessed for ability to receive IV contrast, even in “non-contrast” situations since changing circumstances may necessitate the use of IV contrast. All use of IV contrast requires IV access; of specific importance is that high-pressure contrast injections require at least an 18-gauge access with a catheter rated to accept high pressures! PICC lines and catheters of 20 gauge or less don’t meet these requirements. This has particular importance for PE and other CT angiogram procedures (aorta, renal arteries etc.) and may render these CT procedures unable to be performed if suitable IV access isn’t available.

• Ideally patients should be NPO X 4 hours before administration of IV contrast, in case of contrast-induced vomiting, but this is optional if there is any urgency to the examination

• Relative weight limit of 400 pounds (both MCG & CMC CT)

• Absolute weight limit of 450 pounds (both MCG & CMC CT)

• Patients with weight over 300 pounds or protuberant abdomens tend to have degraded image quality

• PE studies in particular suffer degradation as weight increases, and a V/Q scan is a better exam in large patients

Cost

• Very expensive

• Carries little mortality or morbidity due to electromagnetic exposure or IV contrast

• MCG MRI can be reached at 1-3566

• Vascular US phone number: 1-5201

• A mobile unit is also present on Thursday and Friday and can be reached at 1-1825

• Less easily available

• Small gauge IV access for IV contrast use is acceptable

• The patient doesn’t need to be NPO, but must be able to lay still

• In cases of claustrophobia or a non-cooperative patient elective sedation may be required; this is arranged and ordered by the referring healthcare provider

• The MCG and mobile MRI (Thursday & Friday only) have weight limits of 300 pounds. Larger patients may require referral to an open MRI; MCG doesn’t have an open MRI at this time

Cost

• NM is moderately expensive

• Carries minimal mortality and morbidity from the radiation and associated labeled radiopharmaceuticals

• MCG NM can be reached at 1-2867

• less available

• Small gauge IV access for IV radiopharmaceutical use is acceptable

• PET/CT is considered as a NM procedure and scheduled via the nuclear medicine department

• Please note that a cooperative patient who isn't artificially ventilated is required for the ventilation part of a lung V/Q scan; if these conditions aren't present then an alternative PE examination should be selected

• The patient should be NPO X 4 hours for GB, GB ejection fraction, and cardiac NM examinations

• Single head (camera) nuclear medicine table has a weight limit of 300 pounds

• Dual head NM table has a weight limit of 350 pounds

• PET/CT table has a weight limit of 300-350 pounds

• There is progressive image degradation as weight increases due to soft tissue attenuation of the gamma rays or positrons being emitted by the radiopharmaceutical.

Cost

• NM is moderately expensive

• A procedural risk of perforation (BE)

• Aspiration of oral contrast media (UGI & SBFT)

• Potential anaphylaxis due to allergic reaction to the latex balloon (BE)

• mortality and morbidity related to radiation exposure

• MCG fluoroscopy: 1-4948

• CMC fluoroscopy: 1-5201

• Specific informed consent is not required

• less available after regular business hours

• Patients scheduled for UGI, SBFT, and BE examinations should be on restricted diet and/or bowel prep before their procedures. Details available in the radiology department.

• The fluoroscopy table has a weight limit of 350 pounds

• Alternatives to fluoroscopy include EGD and Colonoscopy

Cost

• Biopsy and angio/interventional procedures are expensive

• Significant procedural risks

• Associated mortality and morbidity from radiation exposure and contrast use (IV, intra-arterial, or intracavitary)

• MCG contact number for angio/interventional: 1-8220

• Availability is by consult to the angio/interventional service. Specific informed consent by the patient or guardian is required in all cases, unless the referring healthcare provider gives emergency consent

• There will be formal pre-op and post-op evaluation and monitoring of the patient to ensure maximum safety during and after the procedure

• Vascular US has no weight limit per se, but very large limbs will have poor quality results or not be able to be meaningfully examined

Cost

• Both plain films and mammography are inexpensive

• Mortality and morbidity related to exposure to radiation

• Mammography can be reached at 1-3260

• Plain films are widely available

• Mammography is available during business hours

• The IVP table has a limit of 325 pounds.  Alternatives to intravenous urography include CT, US, MRI, and cystoscopy/retrograde pyelography.

• Plain films have no fixed weight limit, but image quality declines with increasing patient weight and/or size. A departmental examination is always of better quality than a portable study due to better quality equipment and higher obtainable radiation parameters.

• Mammography has no specific weight limit.

Cost

• MRI contrast doesn't require specific informed consent. MRI and CT IV contrast are both quite expensive!

• CT IV contrast contraindications include Creatinine of 2.0+, allergy to iodine or contrast, renal failure, or lack of consent. 

• Informed consent or emergency consent signed by the referring provider is required in all cases. Minors, incapacitated patients, or incompetent patients require consent from a guardian or emergency consent as above.