At Froedtert & The Medical College of Wisconsin, patients benefit from the combined strength of a group of experienced general radiologists and radiologists who are highly specialized in specific areas of diagnostic radiology.
Breast ImagingFour radiologists at Froedtert & The Medical College of Wisconsin specialize in breast imaging to detect diseases of the breast, including cancer, fibrocystic disease (benign changes in breast tissue), benign tumors, ductal disorders and other problems.
The Radiology Department uses state-of-the-art breast imaging technology, including:
Men and Breast Disease
- Mammography — a screening mammogram is performed to detect breast changes in women who have no signs or symptoms of breast cancer. Screening mammography usually involves taking two X-rays of each breast to detect tumors and microcalcifications (tiny calcium deposits in the breast) that may indicate the presence of breast cancer. A diagnostic mammogram, which requires more images, is done to check for breast cancer after a lump or abnormality has been found on a screening mammogram or by self-examination or physical examination.
Mammography has other special applications for diagnosing breast disease:
- Breast biopsy — when a biopsy is required to test abnormal tissue for cancer, mammography may be used. For a core needle biopsy, mammography helps to locate the abnormal tissue. This is called a stereotactic or X-ray guided biopsy. A core needle biopsy may be done when no lump has been felt, but a mammogram has shown a mass, microcalcifications or an abnormal tissue change. To do the biopsy, a computer analyzes information from mammograms to determine exactly where to place the needle tip in the abnormal area. Once the area is located, a needle with a special cutting edge is inserted through a small incision in the skin, and a small core of tissue is removed.
- Galactogram (also called ductogram), a type of mammogram used to diagnose the cause of an abnormal nipple discharge. A contrast material (“dye”) is injected into a breast duct through the nipple, and the breast is then imaged with mammography.
- Breast ultrasound — specially trained technologists perform breast ultrasound to view lumps in the breast, nipple discharge and as a follow-up exam to a mammogram that showed changes in the breast. Because ultrasound does not use radiation, it’s especially useful for examining the breasts of pregnant women and women under age 25.
Ultrasound is also used to perform fine-needle and core-needle biopsies of the breast. When an abnormal area in the breast is too small to be felt, ultrasound can locate the abnormal area and help the physician pinpoint where to place the needle to remove tissue for the biopsy.
- A fine needle aspiration (FNA) uses a thin needle to draw out cells and/or fluid from the abnormal area.
- A core needle biopsy uses a slightly larger, hollow “core” needle with a special cutting edge to withdraw small cores of tissue from the abnormal area.
- Breast MRI — Magnetic resonance imaging (MRI) of the breast is used as a supplemental tool for detecting and staging breast cancer and other breast abnormalities. MRI is not a replacement for mammography or ultrasound imaging of the breast.
MRI is used to image the breast in certain situations, and should not replace standard screening such as breast self-examination, physical examination by a physician and mammography. A woman must have a mammogram exam before an MRI exam can be scheduled.
Breast MRI may be used to:
- Detect breast cancer in women who are at increased risk of breast cancer and have dense breast tissue
- Evaluate the extent of cancer in women known to have breast cancer
- Evaluate a woman’s response to chemotherapy for breast cancer
- Detect cancer in women at high risk for breast cancer due to a genetic mutation
- Detect breast cancer in women with silicone breast implants and to evaluate implant ruptures
Women whose MRI images show abnormalities also have an ultrasound exam as a “second look.”
Although rare, men can also get breast cancer. The most common cause of a breast lump in males is gynecomastia, the excessive development of the breasts in males. This is usually due to a hormonal imbalance or treatment with certain drugs. Mammography and ultrasound are effective in imaging the breasts of men.
Cardiac Radiology Non-invasive cardiac imaging provides high-quality images to diagnose heart disease. Within the Radiology Department at Froedtert & The Medical College of Wisconsin, cardiac imaging encompasses:
- Cardiac MRI — Cardiac MRI is considered when other types of imaging of the heart do not provide a clear answer. Cardiac MRI requires dedicated specialists and technologists skilled in performing and interpreting MRI scans of the heart.
MRI takes very detailed pictures and gives three-dimensional views of heart function, structure and blood flow through the heart. Because the heart beats constantly, MRI uses advanced technology to “freeze” the motion of the heart, to time the images with the heart’s rhythm.
MRI can help diagnose many types of heart problems, such as congenital heart disease, damage to the heart from a heart attack, cardiac tumors and valve disorders. It is best for diagnosing and characterizing tumors and congenital defects of the heart.
MRI can detect how much damage heart muscle has undergone after a heart attack. It can pinpoint how much damage has been done and how much living muscle remains — important information when considering angioplasty, a stenting procedure or cardiac bypass surgery.
What to Expect Before, During and After Your Cardiac Stress MRI
- 64-Slice Volume Computed Tomography (VCT) — this high-speed CT scanner produces extremely sharp 3-D images of the beating heart. In just a few minutes, a doctor can view a single scan to assess three major heart dangers: clogged arteries, a torn aorta or a pulmonary embolism.
Gastrointestinal (GI) radiology involves imaging to screen the GI tract for various disorders and to check the GI tract following treatment (especially surgery) for a wide range of disorders. Fluoroscopy, an imaging tool that makes a moving X-ray picture of internal organs, is the main type of imaging used for GI disorders.
The GI tract, about 28 feet long, consists of the upper and lower GI sections. The upper GI tract consists of the mouth, pharynx, esophagus and stomach. The esophagus extends through the chest to the stomach, which, in turn, leads to the small intestine. The lower GI tract comprises the small and large intestines (bowels) and anus. Related organs include the liver, which secretes bile into the small intestine (using the gallbladder as a reservoir), and the pancreas, which secretes fluid and enzymes into the small intestine. Both of these organs aid in digestion.
Screening exams may be done to check for GI diseases such as:
- Gastroesophageal reflux disease (GERD), a backflow of acid from the stomach into the swallowing tube or esophagus; GERD is also called acid reflux or heartburn
- Swallowing disorders
- Inflammatory bowel disease (IBD), an inflammatory condition of the large intestine and, in some cases, the small intestine
Froedtert & The Medical College specialize in performing small bowel follow-through imaging for people with Crohn’s disease, a form of inflammatory bowel disease. This test uses fluoroscopy to look at the entire small intestine.
GI imaging is also done to support many areas of patient care. Examples include:
- Checking the GI tract for leaks or complications following bariatric and other types of surgery
- Assessing the placement and effectiveness of tubes placed in the GI tract, such as feeding tubes
GU RadiologyGenitourinary (GU) radiology involves diagnosing diseases of the genitourinary system — the genital tract (reproductive organs) and the urinary tract.
- The urinary tract includes the kidneys, ureters, urinary bladder, sphincter muscles and the urethra.
- The male reproductive system includes testes, reproductive ducts (epididymis, ductus deferens, ejaculatory duct, and urethra) glands (seminal vesicles, prostate gland, and bulbourethral gland), the scrotum and penis.
- The female reproductive system includes the ovaries, Fallopian tubes, uterus, vagina, vulva (includes the labia, clitoris and urethra) and cervix.
Fluoroscopic CT, ultrasound and MRI, combined with interventional techniques, are the major forms of imaging used for genitourinary imaging. These imaging devices are effective in detecting cancerous and non-cancerous diseases of the kidney, bladder, prostate gland and female reproductive system. Follow-up imaging is also important in cancer care to determine the effectiveness of treatment.
Other GU disorders include stones in the urinary tract, blockages in a woman’s Fallopian tubes (during a fertility examination), inflammatory disease, injuries (resulting from trauma) and infections Imaging is also used to assess the placement and effectiveness of tubes placed in the genitourinary tract, such as an ostomy tube.
Musculoskeletal RadiologyThe musculoskeletal system consists of the bones (skeleton) and muscles, as well as tendons, ligaments, joints, cartilage and other connective tissue (the tissue that binds other tissues and organs together).
Musculoskeletal imaging is done to diagnose a wide range of disorders such as traumatic injuries, arthritis, rheumatologic disease and orthopaedic oncology (tumors of the bone and soft tissue). Imaging is also done to diagnose deformities and congenital disorders of the bones and joints, complex foot problems, metabolic bone disease, osteoporosis and many other disorders of the bones, muscles and soft tissue.
Radiologists with a special focus on the musculoskeletal system interpret images using a variety of imaging tools, such as X-ray (including bone densitometry), CT, MRI, nuclear medicine/PET, ultrasound and fluoroscopy.
- CT provides a detailed picture of bone anatomy and conditions such as fractures, infections and tumors
- MRI aids in the diagnosis of bone and soft tissue disease and abnormalities
- Nuclear medicine/PET helps identify sites of active disease
- Ultrasound is used to study soft tissue surrounding bones and joints, and allows observation of a body part as it moves in real time
Imaging (fluoroscopy, CT and ultrasound) is also used to guide interventional procedures in the bones, joints and muscles, such as determining where to place a needle for a biopsy (to obtain a tissue or fluid sample), sampling a joint for fluid or injecting a joint with therapeutic drugs.
NeuroradiologyNeuroradiology is the imaging of the nervous system — the head, brain, spine and neck. Imaging is used to look for tumors, injuries, the source of headaches and vascular disorders in the brain (stroke, aneurysm, carotid stenosis [blocked and narrowed carotid artery in the neck] and vessel malformations). The neuro-imaging group of Froedtert & The Medical College Radiology has earned an international reputation for excellence in producing brain and spinal cord images.
Technology used for imaging the head, brain, neck and spine includes MRI, functional MRI, nuclear medicine/PET/CT, CT angiography, MR angiography, diffusion MRI, MR spectroscopy, ultrasound, SPECT, magnetoencephalography (MEG), myelography and arteriography.
Nuclear medicine and PET studies are interpreted by neuroradiologists in conjunction with nuclear medicine specialists.
Thoracic Radiology Imaging of the thorax (chest) encompasses a wide range of disorders. The thorax contains the lungs, heart and part of the aorta. The chest wall is supported by vertebrae, ribs and the sternum. Radiologists at Froedtert & The Medical College of Wisconsin specialize in interpreting images of the chest area.
Imaging of the chest includes:
- 64-Slice volume computed tomography (VCT) to detect heart disease, evaluate the thoracic aorta, and for post-operative evaluation of heart surgery (including heart transplant)
- Computed tomography (CT) to detect lung disease, evaluate the lungs before and after a lung transplant, detect a pulmonary embolism, pulmonary hypertension and chronic lung problems such as chronic obstructive pulmonary disease (COPD), emphysema and pulmonary fibrosis
- X-ray, CT and positron emission tomography (PET) to evaluate and stage lung cancer
- CT to help physicians guide needles through the chest wall to perform lung biopsies.
Author: Marla Fraunfelder
Last Review Date: Oct. 25, 2013
Online Editor(s): Shannon Krause