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Bone Densitometry

Bone density scanning, also called dual-energy x-ray absorptiometry (DXA) or bone densitometry, is an enhanced form of x-ray technology that is used to measure bone loss. DXA is today’s established standard for measuring bone mineral density (BMD).

An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.

DXA is most often performed on the lower spine and hips. In children and some adults, the whole body is sometimes scanned. Peripheral devices that use x-ray or ultrasound are sometimes used to screen for low bone mass. In some communities, a CT scan with special software can also be used to diagnose or monitor low bone mass (QCT). This is accurate but less commonly used than DXA scanning.

E.E.G. & NCV / EMG

ECG

An electrocardiogram (ECG or EKG) is a commonly used, non-invasive procedure for recording the electrical activity of the heart. Electrocardiography is the starting point for detecting many cardiac problems (chest pain, shortness of breath, palpitations, etc.). It is used routinely in physical examinations and for monitoring the patient’s condition during and after surgery, as well as during intensive care. It is the basic measurement used for tests such as exercise tolerance. The ECG works mostly by detecting and amplifying the tiny electrical changes on the skin that are caused when the heart muscle “depolarises” during each heartbeat.

EEG

Electroencephalography (EEG) is the recording of electrical activity along the scalp. EEG measures voltage fluctuations resulting from ionic current flows within the neurons of the brain. In clinical contexts, EEG refers to the recording of the brain’s spontaneous electrical activity over a short period of time, usually 20–40 minutes, as recorded from multiple electrodes placed on the scalp. Diagnostic applications generally focus on the spectral content of EEG, that is, the type of neural oscillations that can be observed in EEG signals. In neurology, the main diagnostic application of EEG is in the case of epilepsy, as epileptic activity can create clear abnormalities on a standard EEG study. A secondary clinical use of EEG is in the diagnosis of coma, encephalopathies, and brain death. A third clinical use of EEG is for studies of sleep and sleep disorders where recordings are typically done for one full night, sometimes more. EEG used to be a first-line method for the diagnosis of tumors, stroke and other focal brain disorders, but this use has decreased with the advent of anatomical imaging techniques with high.

EMG

Electromyography (EMG) is a technique for evaluating and recording the electrical activity produced by skeletal muscles. EMG is performed using an instrument called an electromyograph, to produce a record called an electromyogram. An electromyograph detects the electrical potential generated by muscle cells when these cells are electrically or neurologically activated. The signals can be analyzed to detect medical abnormalities, activation level, recruitment order or to analyze the biomechanics of human or animal movement.

NCV

Nerve conduction velocity is the speed at which an electrochemical signal propagates down a neural pathway. Many things can affect this, including axon diameter, myelination, the internal resistance of the axon, and temperature. Nerve conduction velocity differs from species to species, and to a lesser degree, from individual to individual.

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PET CT

Positron emission tomography–computed tomography (better known as PET-CT or PET/CT) is a nuclear medicine technique which combines, in a single gantry, a positron emission tomography (PET) scanner and an x-ray computed tomography (CT) scanner, to acquire sequential images from both devices in the same session, which are combined into a single superposed (co-registered) image. Thus, functional imaging obtained by PET, which depicts the spatial distribution of metabolic or biochemical activity in the body can be more precisely aligned or correlated with anatomic imaging obtained by CT scanning. Two- and three-dimensional image reconstruction may be rendered as a function of a common software and control system.

PET-CT has revolutionized medical diagnosis in many fields, by adding precision of anatomic localization to functional imaging, which was previously lacking from pure PET imaging. For example, many diagnostic imaging procedures in oncology, surgical planning, radiation therapy and cancer staging have been changing rapidly under the influence of PET-CT availability, and centers have been gradually abandoning conventional PET devices and substituting them by PET-CTs. Although the combined/hybrid device is considerably more expensive, it has the advantage of providing both functions as stand-alone examinations, being, in fact, two devices in one.

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Gamma Scan

Gamma Scan

A gamma camera (γ-camera), also called a scintillation camera or Anger camera, is a device used to image gamma radiation emitting radioisotopes, a technique known as scintigraphy. The applications of scintigraphy include early drug development and nuclear medical imaging to view and analyze images of the human body or the distribution of medically injected, inhaled, or ingested radionuclides emitting gamma rays.

Imaging techniques

Coded aperture mask for gamma camera (for SPECT) Scintigraphy (“scint”) is the use of gamma cameras to capture emitted radiation from internal radioisotopes to create two-dimensional images.

SPECT (single photon emission computed tomography) imaging, as used in nuclear cardiac stress testing, is performed using gamma cameras. Usually one, two or three detectors or heads, are slowly rotated around the patient’s torso.

Multi-headed gamma cameras can also be used for positron emission tomography (PET) scanning, provided that their hardware and software can be configured to detect “coincidences” (near-simultaneous events on 2 different heads). Gamma camera PET is markedly inferior to PET imaging with a purpose-designed PET scanner, as the scintillator crystal has poor sensitivity for the high-energy annihilation photons, and the detector area is significantly smaller. However, given the low cost of a gamma camera and its additional flexibility compared to a dedicated PET scanner, this technique is useful where the expense and resource implications of a PET scanner cannot be justified.

Construction

Diagrammatic cross section of a gamma camera detector.

Details of the cross section of a gamma camera A gamma camera consists of one or more flat crystal planes (or detectors) optically coupled to an array of photomultiplier tubes in an assembly known as a “head”, mounted on a gantry. The gantry is connected to a computer system that both controls the operation of the camera and acquires and stores images. The construction of a gamma camera is sometimes known as a compartmental radiation construction.

The system accumulates events, or counts, of gamma photons that are absorbed by the crystal in the camera. Usually a large flat crystal of sodium iodide with thallium doping in a light-sealed housing is used. The highly efficient capture method of this combination for detecting gamma rays was discovered in 1944 by Sir Samuel Curran whilst he was working on the Manhattan Project at the University of California at Berkeley. Nobel prize-winning physicist Robert Hofstadter also worked on the technique in 1948.

The crystal scintillates in response to incident gamma radiation. When a gamma photon leaves the patient (who has been injected with a radioactive pharmaceutical), it knocks an electron loose from an iodine atom in the crystal, and a faint flash of light is produced when the dislocated electron again finds a minimal energy state. The initial phenomenon of the excited electron is similar to the photoelectric effect and (particularly with gamma rays) the Compton effect. After the flash of light is produced, it is detected. Photomultiplier tubes (PMTs) behind the crystal detect the fluorescent flashes (events) and a computer sums the counts. The computer reconstructs and displays a two dimensional image of the relative spatial count density on a monitor. This reconstructed image reflects the distribution and relative concentration of radioactive tracer elements present in the organs and tissues imaged.