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    Screening/Preventative Studies


    Screening Examinations Overview
    Because Pueblo Radiology believes that screening imaging studies should be part of a physician-guided comprehensive well-person evaluation, we strongly urge you to seek the guidance of your physician.  In this way, your testing can be tailored to your specific concern, and other important testing, like lab tests, can also be performed.

    Information regarding mammography (link), bone densitometry (DEXA) (link), stroke/vascular screening ultrasound (link), and whole breast ultrasound (link) can be found by following the respective link provided.

    Screening CT Services
    The Pueblo Radiology whole body CT scan is a personalized scan that can detect the presence of many common forms of cancer in their early stages, so that a patient and their physician can take the necessary actions for early intervention. As opposed to the "street corner" or mobile operations that provide a similar service, we only work with a physician referral. These studies, while extraordinary in the amount of information generated, must be evaluated based on your age and the associated radiation dose, as well as with the patient’s entire heath care picture in mind.

    Pueblo Radiology uses the Siemens Sensation 16 CT scanner. This 32 slice/second scanner provides high speed, low dose, and high image resolution.  The image quality of this scanner allows our radiologists to see fine anatomical details that could not be seen previously without surgery. The actual scan is performed in less than one minute, and consists of scans through the lungs and the organs of the abdomen and pelvis. Our board certified radiologists look for signs of possible heart disease, lung disease, aortic aneurysms, and tumors (cancer) in the chest, abdomen, and pelvis. They also check for non life-threatening conditions including gallbladder and kidney stones, and degenerative disease of the spine.

    This whole body scan is designed for people with no medical complaints, and who make a personal choice with their physician to undergo a screening exam. While a whole body scan may not be appropriate for you, portions of the examination, such as cardiac calcium scoring or lung nodule detection can be very valuable. Regular evaluations by your personal physician remain the cornerstone of your medical care. Be sure to call us or ask your doctor about screening CT services at Pueblo Radiology.

    CT Colonography

    The risk of intestinal cancer currently ranks as the second most common form of lethal carcinoma. The main risk of developing intestinal cancer results from polyps located in the large intestine, which may eventually grow to become malignant tumors.

    Intestinal cancer testing is recommended in patients over 50 years of age. If the polyps are identified in time and removed while in a benign state, you may be able to prevent their development into a cancerous condition. The "gold standard" to visualize colon polyps is still the colonoscopic examination, however, an increasing number of articles are touting the use of CT colonography.  By comparison, a CT examination is much less complicated and relatively painless for visualizing clinically significant polyps.

    Who is a high risk person?
    You belong to a high-risk group if any of the following factors apply to you:

    • Presence of polyps
    • You indulge in high fat and/or high meat diet
    • You are hereditarily at risk
    • Ulcerative colitis
    If one of the above points apply to you, contact your physician to find out if a CT Colonography study is appropriate for you.

    How is the examination performed?
    Patient preparation is required so that the intestine is as empty as possible. The actual scan time is approximately 25 seconds and it is performed using a special technique to reduce the radiation dose. The images obtained will be created in a manner to look like a three-dimensional flight through the patient's intestine. Numerous studies have shown that clinically significant polyps can be identified using this examination method.

    If the exam result is negative, the doctor may not advise any additional follow-up. If positive, the polyps, depending on their size, may have to be removed. Smaller polyps are generally followed over time and removed only in the case where they continue to grow.

    Who should have CT Colonography?
    CT Colonography is an appropriate screening option for the following individuals:

    • 50+ years of age
    • Family history of colon cancer
    • Unsuccessful colonoscopy in the past
    • Persons unable to undergo anesthesia
    • Any person needing a screening examination of their colon

    What is CT Colonography?
    CT Colonography (CTC) is an advanced non-invasive method for colon cancer screening. It allows doctors to look at the large bowel (colon) to detect polyps and cancers. Polyps are small growths in the colon that may become cancerous if they are not removed.

    Has this been scientifically studied?
    Research performed at University centers has shown that CT Colonography is better able to see polyps than a double contrast barium enema study and is nearly as accurate as conventional colonoscopy for polyps most likely to become cancerous. It is hoped that CT colonography can increase the relatively poor compliance of colonoscopy, which is performed on only about 15% of patients eligible.

    Why is it important?
    Colorectal cancer (CRC) is a leading cause of cancer related deaths in the United States. Approximately 140,000 cases of colon cancer will be diagnosed in the U.S. this year and 60,000 patients will die of the disease. Colon cancer can be prevented if polyps are discovered and removed early. Tumors (masses of abnormal cells) take years to develop. Polyps when detected can be removed preventively. Nevertheless, individuals at greatest risk of developing colorectal cancer remain largely "under-screened" due in part to poor public awareness and to poor public acceptance of current screening techniques.

    How is a CT Colonography done?
    We use Computed Tomography (CT) of the abdomen and pelvis. This allows radiologists (physicians with advanced training in diagnostic medical imaging) to interpret pictures on a computer with software that creates images similar to those seen by conventional colonoscopy. Patients need a cleansing preparation of their bowels prior to the test. The actual CT Colonography procedure will begin by inserting a small flexible tip into the rectum so that CO2 can be gently introduced. A CT scan is then performed while the patient lies comfortably on their back and then on their stomach. The total time required for the study is 20-30 minutes. Because sedation is not required, patients are able to leave the CT center immediately without the need of observation. Patients can resume their normal activities after the procedure, including eating, working or driving. The radiologist will analyze the CT data and your physician will receive a report of the findings within 24 hours.

    Should I be concerned about the radiation I will be exposed to during my examination?
    Radiation in CT examinations is minimal due to modern technology and the brief duration of the examination. A benefit to the Pueblo Radiology scanner (the Siemens Sensation 16) is the radiation exposure to patient can be reduced by up to 30% compared to other makes of CT scanner.

    How often should I have this test done?
    If you have no history of colon cancer and are of the age 50 or older, physicians usually recommend having a CT Colonography study done once every five years.

    Is it painful?
    When air (CO2) is introduced into the colon, some patients experience mild abdominal cramping or "gas pains;" an intravenous injection of a widely used medicine (Glucagon) to relax the bowels can be given to help reduce gas pains, but this is usually not necessary. CT colonography is much more comfortable than standard colonoscopy. Following the procedure, the gas within the colon is absorbed by the colon lining, breathed off, or expelled in a normal way.

    What is the cost of the test?
    The cost of the test is $775.


    Will you bill my insurance company for me?
    Not all insurance companies cover the examination. A cash or credit card payment is expected at the time of the exam. You will be given a statement, which you may then submit to your insurance company for reimbursement in case your insurer considers this test a covered service.

    How do I get the results of my test?
    You may request a copy of your report at the time of your appointment.

    What if I don't have a treating physician?
    We encourage all patients to have a physician to whom the results can be sent. If you don't have a physician, you will be provided with the results. Those patients, who have been determined to be at high risk based on their CT exam, will be urged to seek the care and evaluation of a physician. A referral list is available.

    CT Cardiac Calcium Scoring

    To assess your risk for heart disease, ask your family doctor about undergoing a screening cardiac calcium CT examination. Such an examination can not only tell you more about the calcium load in your coronary arteries (a known predictor for the risk of having a heart attack), but also is an indicator for the presence of cardiac blood vessel lesions called "plaques". Plaques cause narrowing in these arteries, reducing blood supply to the heart muscle, which may lead to a heart attack.

    Only early diagnosis can ensure timely action to reduce the risk factors and initiate treatment, if necessary, to help prevent the onset of significant heart disease.

    Who is a high risk person?

    You belong to a high-risk group if any of the following factors apply to you:
    • You have high cholesterol level
    • You have high triglyceride values
    • You smoke
    • You have high blood pressure
    • You are hereditarily at risk
    • You have diabetes
    • Any of the factors in combination with a sedentary lifestyle
    If one or more of the above points apply to you, contact your physician to find out more about how CT can help in the evaluation of your heart.

    What examination methods are available?
    Cardiac Calcium Scoring: This examination evaluates the amount of calcium in your coronary arteries, which is a predictor of cardiac disease. A positive coronary calcium score result serves as a good indicator of the risk for certain types of heart attack. A negative calcium score result is a good indicator that coronary vessels are intact. The examination is performed in approximately 15 seconds with a relatively low radiation dose.

    CT Coronary Angiography: This test is not offered in our offices, but can be obtained at St Johns Regional Medical Center in Oxnard – this test needs to be done on a CT scanner having at least a 128 slice capability.  This highly detailed examination is performed by injecting a contrast material into a vein in the patient's arm, which then will enhance seeing the coronary vessels. This will make it possible to obtain a complete 3-D scan of the heart, "a "virtual trip through the heart", without a catheter. The actual scan takes only 20 seconds, within an examination time of 30 minutes. The precise results of this examination will give the patient's doctor information about the condition of the patient's coronary vessels.

    CT Lung Screening (Low Dose)

    Risk of Lung Cancer
    Throughout the world, carcinoma of the lung is the most commonly occurring form of cancer. Since the symptoms of this disease usually first appear in its advanced stages, the chances of recovery are often quite poor. However, if lung nodules (cancers) can be diagnosed early, before they have a chance to spread, the likelihood of a successful recovery is increased.

    Who is a high-risk person? 
    You belong to a high-risk group if any of the following factors apply to you:

    • You have smoked for more than 10 years
    • You are hereditarily at risk
    • You are professionally at risk
    • You are over 60 yeas old
    If one or more of the above points apply to you, contact your physician to find out if a CT screening scan of the lungs might be appropriate for you.

    How is the examination performed?
    A CT scan is performed, with a low radiation dose, in just 15 seconds. If the result is negative, clinically significant lung lesions/nodules can be excluded with very high probability. If positive, further diagnostic measures appropriate for the severity of the suspected disorder may be are required.

    What is low dose screening CT for lung (pulmonary) nodules?
    This is a screening technique that has been discussed in recent medical literature as an extremely sensitive method of detecting early and potentially curable lung cancers, while they are still very small nodules, i.e. less than 1 cm in size.

    Who would benefit from this technique?
    The technique is primarily designed for people over 50, and those who have a greater than 20 year history of smoking.

    How long does the test take?
    Once the patient is on the CT Scanner, the test should take no more than 15 minutes.

    Are there any injections, or is this painful?
    There are no injections. This is not a painful test. It merely requires one to hold their breath for roughly 20 seconds.

    If this test is negative, does that mean I do not have lung cancer?
    A negative is never absolute, however, it is extremely accurate in the detection of small lung nodules, the earliest sign of lung cancer. A small cancer that may arise in the tracheal / bronchial tree may not be detected by this technique.

    If the test is positive, what does that mean?
    It means you have one or more small lung nodules.

    Does that mean I have lung cancer?
    No. The test is designed to detect small nodules in the lung. If you have a positive test (one or more nodules), a high resolution (more detailed) CT Scan will be performed. The purpose of this is to further characterize the lesion, to look for certain features that make it more suspicious for cancer, or more likely to be benign.

    If the test is positive, does it mean I will need surgery?
    Not necessarily. Depending on the number, size and characteristics of the nodules, some patients will go on to have a lung biopsy. This is usually under CT guidance with local anesthesia. A sample of the nodule is obtained through a needle. Some patients may go directly to surgery. There is a large sub-group of patients who will have a recommendation for a follow-up study to try to determine the growth of the nodule.

    What is the cost of the examination?
    The cost of the study is $350. This is a significant reduction over the cost of a standard CT Scan on the chest.

    Will my insurance company pay for this examination?
    At this point in time, most insurance companies will not pay for this test. A payment will be requested for this at the time of service. We will be happy to bill your insurance company so that you can be reimbursed (if applicable). Medicare will not pay for this type of screening examination.

    How do I get my results?
    A report will be sent to your physician and you may request a copy at the time of your appointment.

    I want to have a cardiac scoring exam for my coronary arteries. Can that be done at the same time?
    Yes. When the examinations are done at the same time, a special price of $525 will be offered. This represents at $175 savings over the cost of the examinations being done separately.

    How much radiation do I get from this test and how does it relate to a chest x-ray?
    The radiation dose is about 20% of that which you would receive from a standard CT scan of the chest. The radiation dose compared to a 2 view chest x-ray is about equal.

    How often do I need this screening test for lung cancer?
    Specific intervals for follow-up testing are yet to be developed. Stay in contact with your primary care physician or specialist for further information.

    CT Total Body Scan

    Full Body CT screening examinations offer physicians a "quick look" at the internal anatomy from the neck through the pelvis, providing views of soft tissues in the neck, and visualizing the lungs, heart and abdominal organs such as the liver, spleen, pancreas and kidneys. Full Body CT screening is used as a preventive or pro-active healthcare measure for healthy individuals who have no symptoms or suspicion of disease. With Full Body CT screening, disease or abnormalities may be detected early in their development. The following disabling or life-threatening diseases may be detected before you are experiencing any symptoms:
    • Aneurysms
    • Kidney & Gall Stones
    • Cancer
    • Ovarian Disease
    • Prostate Disease
    • Heart Disease
    • Vascular Disease
    In addition to producing images of superb clarity, the CT scanner used at Pueblo Radiology is comfortable and fast. The ultra-fast techniques used allow entire sections of body, such as the lungs, to be scanned in just 20 to 30 seconds. There is no special preparation for a CT screening examination. Pueblo Radiology will send a full report of the findings to your referring physician.

    A CT Scan is considered a safe radiology procedure. However, because x-rays are used, women cannot have a CT screening examination performed if they are pregnant or think they might be pregnant.