SCHEDULE AN APPOINTMENT: CALL 702.732.6000

Frequently Asked Questions

Appointment Scheduling

How do I schedule an appointment?

For general imaging, by phone: 702-732-6000 (option 1). For special procedures, by phone: 702-515-434 For PET scans, by phone: 702-515-8425

Who can I call if I have questions about my exam prep?

Please call our Scheduling Department at 702-732-6000 (option 1).

What should I bring with me to my appointment?

Please bring a copy of your insurance card, a valid ID, and a list of any medications you are currently taking.

Can I pay my bill online?

Yes. Click here.

How can I find out my account balance?

Please call our billing office at 702-732-6000 (option 3).

Do you take my insurance?

We accept most major insurances. For a comprehensive list of insurances accepted at each site, please see our page regarding insurance (click here).

Does SDMI file my insurance for me?

Yes. SDMI will file your primary and/or secondary insurance to verify what portion of your visit they will cover. Any residual balance will be billed back to you, the patient.

What do I need to pay at the time of visit?

Time of visit charges vary greatly by the type of insurance and type of procedure. To find out exactly what you will need to pay at the time of service, please call our Imaging Valet line at 704-442-4390.

How soon can I get the results of my scan?

You will need to obtain the results of your scan from your referring provider. Your provider will have a copy of your report within a week of your visit date.
Authorization for Imaging

What is authorization?

Authorization is an insurance company's way of giving you permission to receive an exam or procedure. It essentially means that they must review your doctor's reasoning for ordering a specific exam to determine if it is medically necessary before they will agree to pay for it. Please Note: The authorization constitutes a medical decision only and does not guarantee benefit payment.

How do I know if I need insurance authorization for my procedure?

Several insurance plans require pre-authorization for some types of Radiology tests, typically MRI, CT, PET Scans, and Nuclear Medicine Cardiac Scans. It is the responsibility of your referring physician to contact your insurance plan, provide information to obtain the necessary authorization and provide the authorization number to SDMI.
Billing

Who do I contact if I have a question about my bill?

Our billing departments can be reached Monday through Thursday from 7:45am until 4:45pm at 702.732.6000 (option 3) to assist you with your billing and insurance questions. If you would like to make a payment on your bill, please send it to the address listed below or use our "Pay Your Bill Online" Portal.

Why am I receiving a fee for a radiologist when I never saw the radiologist?

Depending on the type of exam that you received, it is possible that you did not physically meet the radiologist at the time of your exam. However, once your images were taken, they were sent to the radiologist to review. The radiologist then interpreted the scans for any signs of abnormality or disease. They then dictated the results of the study and send a copy to your attending and/or referring physicians. When needed, the radiologist also consults personally with your physician to let them know what they have seen on your exam. So the radiologist is actually very active in your medical care, but sometimes it is behind the scenes!
Co-pays & Deductibles

Will I have an out-of-pocket expense for this procedure?

The amount an insurance company pays for a test is dependent upon the co-pay, co-insurance, and any deductible amounts that need to be satisfied. It is best to check with your insurance company to determine what your out-of-pocket expense will be on your procedure.

What is co-payment, co-insurance or deductible?

A co-payment (co-pay) is a fixed dollar amount that patients pay for physician office visits, prescriptions or hospital services. Coinsurance is a defined percentage of the charges for services rendered that a patient must pay. A deductible is the amount of eligible expense a person must pay each year from his/her own pocket before the insurance plan will make payment for eligible benefits. Auto insurance works similarly...if in an accident, a deductible is typically paid before the insurance will pick up the tab for the remainder of the repair bill.

If I haven’t met my deductible yet, does it matter if I bill my procedure to insurance? I’m just going to be paying for it myself anyway.

Allowing your services to be billed to your insurance plan will help to satisfy your mandatory insurance deductible. Once this deductible is met, your insurance provider will then make payment for future allowed services, thus minimizing any future out of pocket costs to you.
Cost of Exams & Procedures

How much is my procedure if I don’t have insurance or don’t want to bill it to the insurance that I have?

Allowing your services to be billed to your insurance plan will help to satisfy your mandatory insurance deductible. Once this deductible is met, your insurance provider will then make payment for future allowed services, thus minimizing any future out-of-pocket costs to you.

I found a quoted price online for an imaging exam. Is it accurate?

Possibly. There are many different sites now that offer pricing information for healthcare exams and procedures so it can be confusing. Many factors that go into determining the price of an exam, such as whether it needs to be with our without contrast. Please contact us at our Scheduling Dept. so that we can give you personalized pricing based on your specific exam and insurance. Scheduling can be reached at 702.732.6000 (option 1).

How much does an imaging exam cost?

There is not one standard price for all imaging exams. There are hundreds of different types of imaging exams, and the prices vary based on many factors, such as whether it needs to be with our without contrast, the type of facility where the exam takes place, the patient's insurance, etc. Please call our Insurance Verification Department so that we can give you personalized pricing based on your specific exam and insurance. The Insurance Verification Department can be reached at 702-732-6000 (option 2).
Insurance

Does SDMI participate with my insurance plan?

SDMI is a preferred provider with numerous insurance plans. Please check with your insurance provider and/or our facility when scheduling appointments to ensure that your procedure will be covered under your plan. Follow the appropriate link below for a list of our most common participating insurance providers.

Will my insurance cover this procedure?

Your insurance coverage is based on criteria outlined in your insurance plan coverage document. It is best to check with your insurance company if you are unsure about whether they will cover the test. Even if your insurance plan covers the test, you will be responsible for any co-payment, co-insurance, or deductible amount specified by your insurance plan.

Do you accept Medicaid?

Yes. The patient must; 1) Provide a copy of their Medicaid card and, 2) sign a waiver that they agree they are responsible for costs not covered by Medicaid.
3D Mammography

How can I get this exam?

As long as you have a referral for a screening mammogram, you can request 3D when you schedule your appointment or when you check in at the front desk upon arrival.

Will I be exposed to more radiation with a 3D exam?

Absolutely not. SDMI installed the GE Senoclair machines, which expose our patients to no more radiation than a traditional 2D mammogram.

Does insurance pay for my 3D Mammogram?

Only Medicare, State Medicaid and Teacher’s Health Trust currently cover this exam. However, even if it is NOT covered, patients may elect to have the 3D mammogram upgrade to their standard mammogram for an additional fee of $50.00. This fee will be in addition to any co-pay and/or deductible that is due for the standard 2D mammogram.

Does the 3D exam take more time?

There are approximately 10-20 times more images taken during the 3D exam, but it only adds a few more minutes to the total scan time of about 15-20 minutes.

What paperwork do I need?

Be sure to bring a screening mammogram referral from your Physician. During registration, you will sign a waiver acknowledging that you are aware that your insurance does not cover the additional cost of 3D mammography.
Angiography / Venography

How do I prepare for an Angiogram/Venogram?

First, your vascular surgeon will authorize blood tests to evaluate blood clotting ability and kidney function. Depending on the Angiogram or Venogram that is required, you may be asked to abstain from food and drink and avoid the use of anti-blood clotting medications.

What happens during an Angiogram?

A nurse or technologist will insert an intravenous (IV) line into a small vein in your hand or arm. A small amount of blood will be drawn before starting the procedure to make sure that your kidneys are working and that your blood will clot normally. A small dose of sedative may be given through the IV line to lessen your anxiety during the procedure. The area of the groin or arm where the catheter will be inserted is shaved, cleaned and numbed with local anesthetic. The radiologist will make a small incision (usually a few millimeters) in the skin where the catheter can be inserted into an artery. The catheter is then guided through the arteries to the area to be examined. After the contrast material is injected through the catheter and reaches the blood vessels being studied, several sets of x-rays are taken. Then the catheter is removed and the incision site is closed by applying pressure on the area for approximately 10 to 20 minutes (or by using a special closure device). When the examination is complete, you may be asked to wait until the radiologist determines that all the necessary images have been obtained. A catheter angiogram may be performed in less than an hour; however, it may last several hours.

What happens during a Venogram?

The physician will insert a needle or catheter into a vein to inject the contrast agent. Where that needle is placed depends upon the area of your body where the veins are being evaluated. As the contrast material flows through the veins being examined, several x-rays are taken. You may be moved into different positions so that the x-rays can take pictures of your veins at different angles.

What will I experience during a Venogram?

You may be asked to remove some or all of your clothes and to wear a gown during the exam. You will feel a slight pin prick when the needle is inserted into your vein for the intravenous line (IV) and when the local anesthetic is injected. The arteries have no sensation. Most of the sensation is at the skin incision site, which is numbed using local anesthetic. As the contrast material passes through your body, you may get a warm feeling. You may have a metallic taste in your mouth and your arm or leg may feel like it is getting numb or “falling asleep.” After the test is complete, this feeling will go away. You must hold very still and may be asked to keep from breathing for a few seconds while the X-ray picture is taken to reduce the possibility of a blurred image. The technologist will walk behind a wall or into the next room to activate the X-ray machine. When the examination is complete, you may be asked to wait until the radiologist determines that all the necessary images have been obtained. A Venogram takes between 30 and 90 minutes to perform. Fluids will be run through your IV to remove the contrast material from your veins and you will be instructed to drink a lot of fluids for the next day. After the catheter is removed, a bandage will be placed on the IV site. You will be observed for any signs of complications, such as bleeding from the injection site, infection or an allergic reaction.

How long will I be in recovery?

After your procedure, it is important that you lie still in order to prevent bleeding. Patients are usually monitored for about 4 hours after the procedure.
Chest & Arm Ports

What is a port?

Your port is a small device (about the size of a quarter) used to carry medicine into the bloodstream. It has one or two small basins that are sealed with a soft silicone top, called a septum. The port is placed under the skin on your chest or arm and connects to a small, soft tube called a catheter. The catheter is placed inside one of the large central veins that take blood to your heart. When a special needle is put into the septum, it created “access” to your bloodstream. Medicine and fluids can be given through the needle and blood samples can be withdrawn. Your port has three bumps on top of each septum. The port with one septum is also shaped like a triangle. These features help the nurse know that your port can receive power injections.

How is my port is accessed and used?

Your doctor or nurse can give medicines or fluids and/or take blood samples through your port. This makes it more comfortable for you. Because the port places medicines into a large central vein, the medicines mix better in the blood. The medicines are also diluted so they are less harmful to your veins. SDMI uses the Bard PowerPort brand of chest and arm port. Before you leave our office, you will receive a packet of information about your port, including an identification card, bracelet and key ring card. Be sure to keep you patient identification card with you at all times. To access the port, your nurse or doctor will place a special needle, called a Huber needle, into the port. You may feel a mild pricking when they put the needle into the port. This sensation often gets milder over time. Ask your doctor or nurse what you should expect.

How do I take care of my port?

After your port is placed, an SDMI nurse will place a dressing over the wound and review the proper care instructions. For the first few days, do not get the dressing wet or remove them unless your doctor tells you to. If the port will be used that day, an access needle will be in the port covered by a dressing. There will also be a small dressing over the top incision. It is common for the incision site to feel sore and this pain should lessen within 24 to 48 hours. You can take over-the-counter pain medicine if you need it, since most patients do not require prescription pain medicine. Wearing a seatbelt may put pressure on your incisions. If so, you can put a small pillow or folded towel between the strap and your body. For the first few days, you should avoid certain activities.
    • Do not perform exercises that involve forceful reaching or stretching.
    • Do not lift anything over 10 pounds while your incision is healing. This is usually about 2 weeks.
    • While you have your port, do not play any contact sports.
Once your incision heals, you will be able to return to your normal daily activities. You can swim with the port once your skin has healed, just as long as there is no needle in the port. The skin over the port only requires normal washing and bathing. You do not need a bandage if the port is not being used. When the port is used, a transparent dressing will cover the needle. It must be kept in place and dry. Most people will not know that you have a port. The port will not set off metal detectors.

What do I do if I have a question or suspect a problem?

After the procedure, you will see some redness and tenderness in the area. This should go away in 24 to 48 hours. However, contact the SDMI nurse if you notice unusual changes in the skin such as increased swelling, redness or soreness. If you have pain, fever, chills, shortness of breath or dizziness, contact us right away at: 702-240-1280.

Will my port need to be accessed when not in use?

Yes. It will need to be flushed every 4 weeks, which is done to make sure the port catheter does not become blocked. If your port becomes blocked, it will no longer work and may have to be removed. The catheter is flushed with a medicine called heparin, which keeps clots from forming. Please notify your doctor if you are allergic to heparin, as you will need a special type of port. Flushing your port needs to be done by a specially trained nurse. Do not allow someone to access your port who is not familiar and trained in port access. Your port will also be flushed right before the needle is removed after each treatment or infusion. If your port is properly maintained, it can stay in place for as long as your doctor feels you need it. It will be removed during a procedure that is similar to how it was put in.

Can the device be removed if I no longer need it?

Yes. The port can be removed by the Interventional Radiology team at SDMI in a simple procedure similar to the one used to place it. Your doctor will let you know when you are ready for your port to be removed.

How do I schedule my port placement or removal?

Scheduling of the insertion or removal of a chest or arm port is handled by a special team who will be able to answer all your questions about the procedure and provide you with the preparation instructions. Please call our Interventional Radiology Scheduling department at: 702.732.6020.
CT

What can you tell me about radiation exposure?

Each patient is an individual, so radiation doses differ from person to person. SDMI customizes radiation doses for each patient, based on a variety of personal factors. This way, the LEAST amount of radiation is used to receive the HIGHEST QUALITY results.

How is the scan done?

In some cases, a dye called contrast material may be used. The contrast may be administered via an IV or an oral contrast and makes it easier to see structures or organs more clearly on the CT images. During the test, you will rest on a table that is attached to the CT scanner and it will send X-rays through the area of the body being studied. Each rotation of the scanner provides a picture of a thin slice of the organ or larger area.

How long does it take?

Scans are usually completed in just a few seconds to minutes.
Dexa Scan

How often should I have this done? Every year or two years?

We recommend that patients receive a DEXA scan at least every two years. In certain situations, such as patients taking Fosomax, it may be appropriate to have an annual study.

Will I be enclosed in a tube like an MRI?

No. You will be lying comfortably on your back and a small sensor will pass over your lower spine and left hip.
Drainage Catheter

What types of catheters are there?

There are two types of drainage catheters: temporary and permanent. A temporary catheter is used for abscesses or post surgical drainage fluids. A permanent catheter is for aiding with end state malignant pleural effusion or ascites. The types of catheters placed at SDMI include: pigtail catheter, pleural catheter and peritoneal catheter.

How do I prepare for my procedure?

SDMI performs outpatient catheterization, and there are a few required steps:
  • Patients should not eat or drink at least six hours before the procedure is performed.
  • Patients should arrive one hour before the procedure is to be performed, with the appropriate physician paperwork.
  • Have a caretaker or guardian available, as the patient will require a ride home.
When the drainage catheter procedure is performed, an intravenous (IV) will be inserted into the skin to provide antibiotics and mild sedatives during the procedure. The patient’s skin will be numbed with a medicine called Lidocaine. Once numbed, a CT or ultrasound scan will be performed and a small nick is made under the skin via a small needle. A wire will then be passed through the needle and the catheter is placed over the wire. Once the drainage catheter procedure is complete, the patient will experience some soreness and discomfort, which may limit some physical activity. Standard aspirin can help to alleviate some discomfort. Positioning of the catheter will be set up and explained by a radiology nurse, along with instructions on how to care for a catheter at home.

How do I care for my catheter?

It is important to take good care of the skin around the drainage catheter in order to prevent infection, which can occur if the catheter gets blocked. The skin must be kept dry and if the bandages get wet, they should be changed immediately. It is also important to make sure the drainage catheter is properly secured to your skin to prevent it from getting snagged or tangled on clothing. It is important to call your referring physician if any of the following occur:
  • The catheter becomes dislodged or broken
  • The stitches become loose
  • The catheter experiences leakage
  • The skin remains reddened and sore for more than 48 hours
  • The catheter has stopped draining

How do I schedule this procedure?

This procedure is considered an Interventional Radiology, or “Special Procedure.” To schedule, call us at 702-732-6000 (option 1).
Flouroscopy

How long do fluoroscopy studies take?

Depending on the purpose, fluoroscopy studies can take as little as 30 minutes to as long as one to three hours.
IVC Filter Placement & Removal

How do I prepare for an IVC Filter Placement?

Preparation is dependent on a few things, such as blood tests, to see if the kidneys are functioning properly or if the blood is clotting normally. Your doctor may advise that you discontinue the usage of aspirin, nonsteroidial anti-inflammitory drugs (NSAIDs) or blood thinners. Insulin users may have to adjust their dosages before the procedure. A light meal is recommended the night before the patient’s procedure, as food and drink will need to be abstained from after midnight of the day before your procedure.

What should I expect before the procedure?

Patients will be asked to wear a dressing gown and remove all jewelry, watches, eyeglasses and personal items, as such metallic objects may interfere with the clarity of the X-ray imaging. The patient will then be positioned on their back and connected to monitors that track blood pressure, heart rate and pulse. A technologist will insert an IV to administer sedative medication or a general anesthesia. The catheter insertion point will be sterilized and numbed with a local anesthetic to allow for a small incision to be made in the skin.

What will I experience during and after the procedure?

Devices to monitor your heart rate and blood pressure will be attached to your body. You will feel a slight pin prick when the needle is inserted into your vein for the IV and when the local anesthetic is injected. The arteries have no sensation. Most of the sensation is at the skin incision site, which is numbed using local anesthetic. If sedation is used, you will remain awake but the intravenous (IV) sedative will make you feel relaxed and sleepy so as to reduce anxiety during the procedure. You may feel slight pressure when the catheter is inserted, but no serious discomfort. As the contrast material passes through your body, you may get a warm feeling. You will remain in the recovery room until you are completely awake and ready to return home. If your IVC filter was inserted through a vein in your neck, you should be able to resume your normal activities within 24 hours. If your filter was inserted through a vein in your groin, you should avoid driving for 24 hours and lifting heavy objects and climbing stairs for 48 hours. The SDMI nurse will provide additional post-procedure instructions before you leave.

How is the procedure performed?

During the procedure, a catheter, X-ray or ultrasound device and an inferior vena cava filter will be used. The catheter, once inserted into the skin via a large vein in the neck or groin, will be advanced to the inferior vena cava (IVC) in the abdomen. The IVC filter is placed through the catheter and into the vein, where the interventional radiologist will release the filter to expand and attach itself to the walls of the blood vessel.

What about removing an IVC Filter?

For removal, another special catheter is inserted in a similar way to the initial procedure and advanced to the filter site. A removable IVC filter bearing a small hook or knob enables the catheter to locate and capture the filter, close it off, pull it to the catheter and remove it from the body.
MRI

How does an MRI procedure work?

The procedure for an MRI utilizes a magnetic field, radio waves and a specialized computer to construct detailed images of the body. Most MRI machines consist of a large, tube-shaped construction that houses a large magnet within the circular area. A patient is required to lie inside the machine, where the magnetic fields inside will temporarily realign hydrogen atoms in a patient’s body. Once the patient lays down on the table or movable bed, the medical technician will slide a coil to the specific area that needs to be imaged. The coil is the part of the MRI machine that receives the signal. An electric current that runs through the wire loops will result in creating a strong magnetic field. Additionally, other magnet coils will send and receive radio waves to trigger protons to realign within the body. As the protons align, the radio waves will be absorbed by those protons and stimulate spinning, which releases energy by these “excited” molecules. The resulting energy is picked up by the magnetic coils and sent to a computer for processing. Once processed, the final imaging result will be a 3D representation of the examined area. The image and resolution that is produced by the MRI scans are quite detailed and can locate small changes of structures within the body. In some of the procedure types, contrast can be used to increase the accuracy of the generated images.

How much preparation do I need to do before my MRI?

There is not much preparation necessary for patients to get ready for an MRI. The patient will arrive at the diagnostic center, dress in a gown and remove all metallic or magnetic objects such as jewelry or credit cards. Given that MRI utilizes magnets in their operation, it can interfere or be damaging to the patient’s property. It can also lead to inconclusive/incorrect results, as well as generate poor quality images. In other instances, patients with heart pacemakers, metal chips, clips or implants are not able to be scanned due to the magnetized effects.

Is an MRI the same as a CT scan?

MRI scanning is different than a CT (Computed Tomography) scan or even general X-ray diagnostics, since there is no ionizing radiation involved. Since the procedure is made up of radio waves, the MRI exam is a painless procedure that will not cause any additional injury or discomfort for the patient. The radio waves are noninvasive, can't be felt by the body and will not tamper with bodily function or sensitivity. The test itself will last anywhere from 30 to 45 minutes on average, but may run longer if multiple scans have to be made. MRI's are one of the safest ways that doctors can get a detailed overview of organs and tissues and is a critical aspect for early detection and diagnosis, as well as the treatment of many diseases and injuries.

How can you help me with my claustrophobia?

We understand that a lot of people are claustrophobic and worry about having an MRI. SDMI is the best place to have your MRI done because our scanners are all "wide bore," meaning they have the largest opening (71 cm) of any scanners on the market. We also offer the option of oral or IV sedation to make patients more comfortable, as well as your favorite genre of music to listen to during the scan to help you relax.
Needle Biopsy/Bone Biopsy

How do I prepare for a biopsy?

Needle biopsy procedures require little to no preparation. In some cases, sedatives may be administered such as intravenous (IV) or conscious sedation. You may be asked not to eat or drink before the procedure, depending on where the biopsy is being performed. Please advise your referring physician if you are taking any medications that are used for blood thinning (such as Cournadin, Warfarin or even aspirin) as you may have to abstain from use before the procedure. This procedure is usually completed within one hour.

What should I expect before the procedure begins?

You will be asked to change into a gown before the procedure and will then lie on a table in a position that makes it easy and accessible for the physician to approach the area for needle insertion. When you are ready for the procedure to begin, the health care team will clean the area where the needle is to be inserted and apply a local anesthetic to numb the skin. Intravenous sedatives may be introduced via the arm to help you relax during the procedure. The site being biopsied may require more than one tissue collection. Your radiologist will walk you though the procedure before anything happens and answer any questions you have before beginning.

How does the procedure work?

Using imaging guidance, the interventional radiologist inserts the needle through the skin and advances it into the lesion. Tissue samples will be removed using either fine needle aspiration or a core needle biopsy.

What should I expect during the procedure?

When you receive the local anesthetic to numb the skin, you will feel a slight pin prick from the needle. You may feel some pressure when the biopsy needle is inserted and the area will become numb within a short time. You will be asked to remain still and not to cough during the procedure. You will also be asked to hold your breath multiple times during the biopsy. It is important that you try to maintain the same breath-hold each time to insure proper needle placement.

What happens after the procedure is done?

Once the biopsy is complete, pressure will be applied to stop any bleeding and the opening in the skin is covered with a dressing. No sutures are needed. You will be taken to an observation area for at least one hour. It is recommended that you relax for the rest of the day of the procedure and keep the bandage in place until otherwise instructed. Residual pain or discomfort from the procedure may only last a day or two.

What is done with the tissue that is collected?

When the radiologist has collected a sufficient number of cells and/or tissues for analysis, the needle biopsy procedure is concluded and the sample is sent to a laboratory for analysis. Depending on the technical scope of the tests, results may be back within a few days. Once sent to a laboratory, a pathologist (a specialist that studies cells and tissue samples for signs of disease) will examine the sample and make a diagnosis based on the findings. The diagnosis will be written into a pathology report and sent to the patient’s physician, who will contact you with the results and discuss what additional options are needed. While patients can request a copy of the pathology report, the reports are often filled with technical terms that would need the expertise of a physician to decipher. Pathology reports often contain the following:
  • Description of the biopsy sample – General description covering color and consistency of collected fluids and tissues.
  • Description of the cells – Description of how the cells look under a microscope, types and number of cells that were seen during the testing procedure.
  • Pathologist diagnosis – Lists the pathologist’s diagnosis and case related commentary, as well as other recommended tests for the patient.
Nephrology

How do I prepare for my procedure?

Prior to your procedure, your blood may be tested to determine how well your kidneys are functioning and whether your blood clots normally. In general, you should not eat or drink anything after midnight on the day of your procedure. However, you may take your routine medications with sips of water. If you are diabetic and take insulin, you should talk to your doctor as your usual insulin dose may need to be adjusted. You will be given a gown to wear during the procedure.

Should I have a driver bring me and take me home?

Yes.

How is the procedure performed?

The area of your body where the catheter is to be inserted will be shaved, sterilized and covered with a surgical drape. The interventional radiologist will numb the area with a local anesthetic. The radiologist will use X-rays and/or ultrasound to locate your kidney and a needle will be inserted through your skin into the kidneys. Contrast dye will be injected through the needle. During ureteral stenting, you are positioned on your stomach. Using a fluoroscope to see the ureter, a guide wire is inserted into the ureter. The stent is run over the guide wire and placed in its permanent position within the ureter. Once the stent has been placed, the guide wire may be removed, or a nephrostomy catheter may be left in place for a day or two and then removed. At the end of the procedure, the catheter will be removed and pressure will be applied to stop any bleeding. The opening in the skin is then covered with a dressing. No sutures are needed upon completion of the procedure. During nephrostomy, you are positioned on your stomach. Using a fluoroscope to see the kidney, a guide wire is inserted into the kidney, followed by a catheter. This will be left in place until a ureteral stent can be placed or the ureteral blockage is resolved. Most commonly, the nephrostomy catheter is connected to an external bag that collects urine. You will be instructed on how to empty and care for the drainage bag prior to leaving the hospital. Your intravenous line will be removed. Both procedures are usually completed within one hour.

What will I experience during the procedure?

Devices to monitor your heart rate and blood pressure will be attached to your body. You will feel a slight pin prick when the needle is inserted into your vein for the intravenous line (IV) and when the local anesthetic is injected. The arteries have no sensation. Most of the sensation is at the skin incision site which is numbed using local anesthetic. You may be given a sedative through IV or conscious sedation, which will make you feel relaxed and sleepy. You may feel slight pressure as the catheter is inserted into the kidney and down the ureter. During placement of a ureteral stent, you may feel pressure as the guide wire is inserted into the bladder. You will remain in the recovery room until you are completely awake and ready to return home. You will not feel when the contrast is excreted into the urine. You should be able to resume your normal activities within a few days.
Nuclear Medicine

What is a Nuclear Medicine scan?

Nuclear medicine scans are considered a noninvasive procedure and outside of intravenous injections, the tests themselves are relatively painless and usually conducted by technicians called Radiographers. Nuclear medicine has been called “radiology done inside out” or “endoradiology” because the process records the radiation that emits internally from within the body, compared to the radiation that is created from external sources such as X-rays. In cases of performing nuclear medicine imaging, radiopharmaceuticals are given internally and presented in an intravenous format or inhaled as gas. Once in place, special imaging devices referred to as gamma cameras (external detectors) take the radiation emitted by the radiopharmaceuticals and use them to create images and provide molecular information. This is similar in practice to a diagnostic X-ray, where the external radiation passes through the body to create its image.
PET

What do these scanners look like and what do they do?

The PET scanner is a large machine that has a round opening in the middle. Inside the circular area are multiple rings or detectors that record the emission of energy from the radiotracers found within the patient’s body. The scanner combines these two types of information, allowing the physician to diagnose any changes in the activity of cells. It also allows physicians to determine exactly where the changes are occurring. A CT scanner is a large box-like machine with a short tunnel in the center of the device. Patients lie on a narrow examination table or bed that slides in and out of the tunnel. X-ray tubes and electronic X-ray detectors are located opposite of each other and are referred to as a gantry. The imaging computer is located in a separate control room. The technician remains in direct visual contact with the patient and will have the ability to converse with the patient via speaker and microphone.
Ultrasound

How do I prepare for my ultrasound?

Being a simple procedure, ultrasounds require little to no preparation, with only a few exceptions:
  • For gallbladder exams, a doctor may require the patient not to ingest food or drink before the procedure.
  • For pelvic exams, a full bladder may be required for testing, so a doctor may ask the patient to drink up to six full glasses of water two hours before the exam without urinating.

What should I expect during my ultrasound?

Jewelry, watches, glasses and even clothing may need to be removed before the exam, requiring the patient to change into a hospital dressing gown. Patients will be asked to lie on an examination table, where a special type of gel will be applied to keep sound-blocking air pockets from forming. Once prepared, a trained technician called a sonographer will press a device called a transducer against the skin where the test is being performed to capture the image. The transducer emits a high-frequency sound (one that is inaudible to human ears) to send sound waves into the body that collect information by determining the size, shape and consistency of organs and soft tissues. This information is sent back to a computer that processes and forms the images. On average, ultrasounds can take anywhere from 30 minutes to up to an hour. The radiologist and doctor will interpret the images in order to help diagnose and treat potential conditions. Once complete, normal activity can be resumed.
Vertebroplasty & Kyphoplasty

What are the benefits of having this procedure?

Vertebroplasty and Kyphoplasty provide several benefits:
  • Allows the patient to return to normal activity. Due to the pain level associated with compression fractures, most patients are unable to perform everyday tasks. The Vertebroplasty procedure is able to stabilize the fracture. Within a few days, most patients are able to resume their previous levels of activity with a new level of improved mobility.
  • Reduces the need for pain medications. The Vertebroplasty process is able to reduce the need, or in some cases fully eliminates the need for related pain medications.
  • Helps to prevent further fractures from occurring. The acrylic cement is able to fill the spaces in the bones that have been weakened by osteoporosis. As a result, the treated bone is less likely to crack or fracture again, eliminating the need for short-term “follow up” visits.

How do I know if I am a candidate?

An SDMI Interventional Radiologist will perform an initial consultation to confirm the presence of a compression fracture that may benefit from Vertebroplasty or Kyphoplasty treatment. The consultation may require prior diagnostic imaging including spine X-rays, magnetic resonance imaging (MRI) and/or a CT scan.

How do I prepare for this procedure?

You will need to have blood drawn for tests prior to the procedure to determine if your blood clots normally. On the day of the procedure, you should be able to take your usual medications with sips of water or clear liquid up to six hours before the procedure. You should avoid drinking juice, cream and milk and be sure to follow your doctor’s instructions. In most cases, you should take your usual medications, especially blood pressure medications. These may be taken with sips of water on the morning of your procedure. Other than medications, you may be instructed to not eat or drink anything for several hours before your procedure. You should plan to have a relative or friend drive you home after your procedure.

How is this procedure performed?

Patients are first given mild sedation through an IV inserted in the arm before the procedure. Once sedated, an interventional radiologist makes an incision near the compression fracture. A tube is placed into the vertebral body and a balloon is then passed down the tube and inflated to restore the height of the vertebral body. Once the vertebra has regained its natural height, special cement is injected into the space and the tube is removed. The cement hardens once in the vertebral body, creating permanent support for the vertebrae.

What should I expect after the procedure?

Once the procedure is completed, the cement will harden in an average of 10 minutes. Patients will then be required to lie on their back for an average of two hours until the cement fully hardens. A bandage will be placed on the patient’s skin where the puncture was and the patient will then be sent on their way. Patients should plan to have a relative or friend drive them home after the procedure. General activities and most regular medications can be resumed shortly after the procedure, though it is recommended that the patient have 24 hours of bed rest once the operation is completed. There may be some related pain around the puncture area, but an ice pack can help to relieve the soreness.
X Ray

How do I prep for an X-ray?

The general preparation is very simple. Once the patient gets to the exam, they will wear a standard dressing gown, depending on what area is being X-Rayed. In some cases, metallic objects such as jewelry, glasses or watches may need to be removed, as they may interfere with the scan and show up in the results. A technologist will help the patient maintain the necessary procedure to record the imaging. In some cases, the patient may need to hold their breath while the testing is being performed to provide a clearer image. In other cases, the patient may be required to wear a lead apron to diminish the amount of radiation. Bone X-Rays may only last a few minutes, though in more complicated cases, procedures can last over an hour. Once the X-Ray is complete, the patient can resume their normal level of activity without side effects. There may also be some slight discomfort depending on the positioning necessary to take the X-Ray.

What happens to my X-Ray after the procedure?

The results of modern X-Rays are saved digitally on computers, which can be viewed in minutes. A radiologist will examine the results and report back to the doctor for patient explanation. In emergency cases, X-Rays can be available in minutes if necessary. X-Rays are performed at all seven SDMI locations.